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Mackay A, Downey LA, Arunogiri S, Ogeil RP, Hayley AC. Trait anger as a predictor of dangerous driving behaviour amongst people who use methamphetamine. ACCIDENT; ANALYSIS AND PREVENTION 2024; 204:107634. [PMID: 38795421 DOI: 10.1016/j.aap.2024.107634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Despite increased prevalence of methamphetamine in road trauma, it remains unclear how its use translates to an increased risk of traffic-related harm. Exploration of psychosocial factors may thus help identify relevant predictors of dangerous driving behaviour among people who regularly consume methamphetamine. METHODS Licenced individuals who report predominant and sustained methamphetamine use (at least 1-time/month for 6 months at heaviest use) were recruited from the Australian community and via targeted campaign (Eastern Health). Psychosocial, substance use and driving behaviour data (Dula Dangerous Driving Index, DDDI) were collected via a secure anonymous online forced-entry survey platform (Qualtrics). RESULTS Seventy-seven individuals (65.5 % male) aged between 20-50 years [mean = 29.7, ± Standard Deviation (SD) 6.1] were included. Most (90 %) respondents met criteria for problematic methamphetamine use [Severity of Dependency Scale (SDS) score ≥ 5], and 75 % were high-risk alcohol consumers [Alcohol Use Disorders Identification Test (AUDIT-C) score ≥ 4 for men and ≥ 3 for women]. On average, age of first methamphetamine use occurred at 23.3 years (±5.2). A best-possible subset's regression selection method with dangerous driving behaviour as the dependent variable determined the model with three predictors (alcohol use, substance dependence severity and trait anger) as most parsimonious. After controlling for substance use, trait anger strongly and positively predicted dangerous driving behaviour as measured by the DDDI ([F(3,74) = 26.06, p < .001, adjusted R2 = 0.50, Cohens f2 = 0.42). DISCUSSION AND CONCLUSIONS Trait anger is a strong predictor of risky driving among road users who use methamphetamine. Interactions between stable negative-emotional and situational traffic and driving-related factors may increase risk of harm through greater engagement in risk-taking behaviour.
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Affiliation(s)
- Aaron Mackay
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Luke A Downey
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia; Institute for Breathing and Sleep, Austin Health Hospital, Melbourne, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
| | - Rowan P Ogeil
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Turning Point, Eastern Health, Richmond, Victoria, 3121, Australia
| | - Amie C Hayley
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia; Institute for Breathing and Sleep, Austin Health Hospital, Melbourne, Australia; International Council for Alcohol, Drugs and Traffic Safety (ICADTS), Australia.
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Chen S, Bade R, Tscharke B, Hall W, Thai P, He C, Ahmed F, Zheng Q, Choi PM, O'Brien JW, Mueller JF. Assessing daily patterns in stimulant use during the COVID-19 pandemic in Melbourne, Australia using wastewater analysis. JOURNAL OF HAZARDOUS MATERIALS 2024; 476:135130. [PMID: 38991639 DOI: 10.1016/j.jhazmat.2024.135130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/16/2024] [Accepted: 07/05/2024] [Indexed: 07/13/2024]
Abstract
During the COVID-19 pandemic, one of Australia's biggest cities, Melbourne, experienced three major isolation ("lockdown") periods in 2020 (160 days) and in 2021 (111 days) which makes it one of the most locked down cities world-wide. This study assessed how the pandemic affected temporal trends in methamphetamine, MDMA and cocaine consumption using wastewater-based epidemiology. Daily samples were collected for most of 2020 and 2021 (n = 660 days). Concentrations were measured using direct-injection LC-MS/MS and back-calculated to consumption estimates. Results indicate that methamphetamine use was increasing before the first lockdown and decreased after the end of the first lockdown in 2020. Methamphetamine trends appeared to have remained steady throughout the second lockdown period before increasing steeply after it ended. For most of 2020, cocaine use remained steady, with an increase after the second lockdown. MDMA use decreased after the start of the first lockdown and remained steady throughout most of 2020 and 2021. In comparison to 2020, trends in 2021 were less variable and stimulant use did not appear to be as associated with COVID-19 restrictions. Overall, this study was able to show the impact of lockdown periods and the related social restrictions on illicit stimulant use. ENVIRONMENTAL IMPLICATION: Illicit drugs are hazardous chemicals, of concern both to humans and the environment. While studies have been undertaken to understand their temporal trends, this work utilizes wastewater-based epidemiology and daily sampling to provide a comprehensive understanding of the impact of the COVID-19 pandemic on the use of methamphetamine, MDMA and cocaine on one of the most locked-down cities in the world. Understanding the consequences of this significant intervention on illicit drug use could provide valuable insights into its potential environmental impact.
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Affiliation(s)
- Shuo Chen
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Richard Bade
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia.
| | - Ben Tscharke
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Wayne Hall
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia; National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Phong Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Chang He
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Fahad Ahmed
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Qiuda Zheng
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Phil M Choi
- Water Unit, Health Protection and Regulation Branch, Queensland Public Health and Scientific Services, Queensland Health, Herston, QLD 4006, Australia
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia; Van 't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, Netherlands
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
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Mantinieks D, Drummer OH, Schumann J, Gerostamoulos D. The analysis of methylamphetamine and para-hydroxy-methylamphetamine in post-mortem hair samples using liquid chromatography-tandem mass spectrometry. Drug Test Anal 2024. [PMID: 38949034 DOI: 10.1002/dta.3765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/02/2024]
Abstract
External contamination is a well-recognized limitation of hair analysis for drugs of abuse like methylamphetamine (MA), and there are no guidelines regarding the analysis of specific metabolites of MA to assist interpretation. We developed an analytical method to detect MA, amphetamine (AMP), and para-hydroxy-methylamphetamine (p-OH-MA) in hair and present their concentrations among a cohort of deceased persons positive for MA in blood (n = 63). Hair samples (≤ 3 cm) were washed with dichloromethane and water prior to extraction using a methanolic micro-pulverization. The reconstituted hair extracts were separated on a UCT Selectra® Aqueous C18 HPLC Column (100 × 2.1 mm, 3 μm) by gradient elution and detected using a Sciex Triple Quad 6500+ system. Validation was satisfactory, and the lower limits of quantitation were 0.01 ng/mg for MA and AMP and 0.001 ng/mg for p-OH-MA. The median hair concentrations of MA, AMP, and p-OH-MA were 13 ng/mg (range = 0.015-49; n = 51), 1.1 ng/mg (range = 0.018-44; n = 60), and 0.020 ng/mg (range = 0.0012-0.38, n = 62), respectively. These concentrations in hair were strongly positively correlated (r = .7202 to .8641, p < .001), suggesting similar modes of incorporation. Moreover, the wash/hair ratios were indicative of external contamination, especially among the soiled group of hair samples. Therefore, further studies are necessary to determine concentrations of p-OH-MA in living MA users and confirm if this metabolite constitutes a potential marker of MA consumption.
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Affiliation(s)
- Dylan Mantinieks
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Southbank, Victoria, Australia
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
| | - Olaf H Drummer
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Southbank, Victoria, Australia
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
| | - Jennifer Schumann
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Southbank, Victoria, Australia
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
| | - Dimitri Gerostamoulos
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Southbank, Victoria, Australia
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
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Alqarni H, Aldghim A, Alkahtani R, Alshahrani N, Altoman MS, Alfaifi MA, Helmi M, Alzaid AA. Crystal methamphetamine and its effects on mental and oral health: A narrative review. Saudi Dent J 2024; 36:665-673. [PMID: 38766295 PMCID: PMC11096620 DOI: 10.1016/j.sdentj.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 05/22/2024] Open
Abstract
The purpose of this comprehensive literature review is to present the available evidence on the effects of methamphetamine on mental and oral health, as well as provide an overview of the most widely used medical and dental care strategies in the management of meth mouth. For this purpose, PubMed and Google Scholar electronic databases were searched for relevant articles, yielding 115 search results, which were further scrutinized for their relevance, leaving 55 for a detailed review. The analysis of the gathered data indicates that a comprehensive patient-centered approach that takes into consideration the physical, mental, and social aspects is crucial for mitigating the detrimental effects of increasing methamphetamine use.
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Affiliation(s)
- Hatem Alqarni
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Adhwaa Aldghim
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rose Alkahtani
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nasser Alshahrani
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Majed S. Altoman
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A. Alfaifi
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Helmi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A. Alzaid
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Makki A, Day C, Chaar BB. Professional stigma towards clients with methamphetamine use disorder - a qualitative study. J Pharm Policy Pract 2024; 17:2306869. [PMID: 38456180 PMCID: PMC10919299 DOI: 10.1080/20523211.2024.2306869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Background Methamphetamine use disorder (MUD) is associated with poor health outcomes. Pharmacists play a role in delivery of substance use treatment, with several studies having examined their attitudes to people with opioid use disorder, but little is known about their attitude towards people with MUD. This study aimed to explore pharmacists' perspectives on the provision of services to clients with MUD. Methods A convenience sampling strategy was used to recruit community pharmacists across Sydney, Australia. Semi structured interviews examined views and ideas of pharmacists surrounding the treatment and management of MUD, followed by coding of transcribed interview data by all members of the research team. Results Nineteen pharmacists completed the interviews. The main theme identified was stigma held by healthcare professionals. The almost unanimous perception amongst pharmacists was fear and apprehension towards people with MUD, including underlying assumptions of criminality, misinformation regarding people with MUD, and lack of education and knowledge surrounding MUD. Conclusion A substantial amount of stigma towards people with MUD was found in this study. Negative attitudes by healthcare professionals can perpetuate healthcare disparities and impede the accessibility of future treatment programs for people with MUD. Appropriate educational interventions on MUD for pharmacists are needed.
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Affiliation(s)
- Ali Makki
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Camperdown, Australia
| | - Carolyn Day
- Faculty of Medicine and Health Addiction Medicine, Central Clinical School, Camperdown, Australia
| | - Betty B. Chaar
- Professionalism Committee School of Pharmacy FMH, Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Camperdown, Australia
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Wang D, Feng Y, Yang M, Sun H, Zhang Q, Wang R, Tong S, Su R, Jin Y, Wang Y, Lu Z, Han L, Sun Y. Variations in the oral microbiome and metabolome of methamphetamine users. mSystems 2024; 9:e0099123. [PMID: 38112416 PMCID: PMC10804968 DOI: 10.1128/msystems.00991-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/09/2023] [Indexed: 12/21/2023] Open
Abstract
Drug addiction can seriously damage human physical and mental health, while detoxification is a long and difficult process. Although studies have reported changes in the oral microbiome of methamphetamine (METH) users, the role that the microbiome plays in the process of drug addiction is still unknown. This study aims to explore the function of the microbiome based on analysis of the variations in the oral microbiome and metabolome of METH users. We performed the 16S rRNA sequencing analysis based on the oral saliva samples collected from 278 METH users and 105 healthy controls (CTL). In addition, the untargeted metabolomic profiling was conducted based on 220 samples. Compared to the CTL group, alpha diversity was reduced in the group of METH users and the relative abundances of Peptostreptococcus and Gemella were significantly increased, while the relative abundances of Campylobacter and Aggregatibacter were significantly decreased. Variations were also detected in oral metabolic pathways, including enhanced tryptophan metabolism, lysine biosynthesis, purine metabolism, and steroid biosynthesis. Conversely, the metabolic pathways of porphyrin metabolism, glutathione metabolism, and pentose phosphate were significantly reduced. It was speculated that four key microbial taxa, i.e., Peptostreptococcus, Gemella, Campylobacter, and Aggregatibacter, could be involved in the toxicity and addiction mechanisms of METH by affecting the above metabolic pathways. It was found that with the increase of drug use years, the content of tryptamine associated with neuropsychiatric disorders was gradually increased. Our study provides novel insights into exploring the toxic damage and addiction mechanisms underlying the METH addiction.IMPORTANCEIt was found that with the increase of drug use years, the content of tryptamine associated with neuropsychiatric disorders gradually increased. The prediction models based on oral microbiome and metabolome could effectively predict the methamphetamine (METH) smoking. Our study provides novel insights into the exploration of the molecular mechanisms regulating the toxic damage and addiction of METH as well as new ideas for early prevention and treatment strategies of METH addiction.
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Affiliation(s)
- Dawei Wang
- Department of Orthopedic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yu Feng
- Department of Orthopedic, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Min Yang
- Department of Immunology, Shandong Provincial Key Laboratory of Infection and Immunology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Haihui Sun
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qingchen Zhang
- Department of Orthopedics, Central hospital affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Rongrong Wang
- Department of Clinical Laboratory, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Shuqing Tong
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Rui Su
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yan Jin
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yunshan Wang
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Zhiming Lu
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Lihui Han
- Department of Immunology, Shandong Provincial Key Laboratory of Infection and Immunology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yundong Sun
- Department of Microbiology, Key Laboratory for Experimental Teratology of Ministry of Education, School of Basic Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Attwood LO, O'Keefe D, Higgs P, Vujovic O, Doyle JS, Stewardson AJ. Epidemiology of acute infections in people who inject drugs in Australia. Drug Alcohol Rev 2024; 43:304-314. [PMID: 37995135 PMCID: PMC10952783 DOI: 10.1111/dar.13772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 08/23/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023]
Abstract
ISSUES People who inject drugs are at risk of acute infections, such as skin and soft tissue infections, infective endocarditis, bone and joint infections and bloodstream infections. There has been an increase in these infections in people who inject drugs internationally over the past 10 years. However, the local data regarding acute infections in Australia has not been well described. APPROACH We review the epidemiology of acute infections and associated morbidity and mortality amongst people who inject drugs in Australia. We summarise risk factors for these infections, including the concurrent social and psychological determinants of health. KEY FINDINGS The proportion of people who report having injected drugs in the prior 12 months in Australia has decreased over the past 18 years. However, there has been an increase in the burden of acute infections in this population. This increase is driven largely by skin and soft tissue infections. People who inject drugs often have multiple conflicting priorities that can delay engagement in care. IMPLICATIONS Acute infections in people who inject drugs are associated with significant morbidity and mortality. Acute infections contribute to significant bed days, surgical requirements and health-care costs in Australia. The increase in these infections is likely due to a complex interplay of microbiological, individual, social and environmental factors. CONCLUSION Acute infections in people who inject drugs in Australia represent a significant burden to both patients and health-care systems. Flexible health-care models, such as low-threshold wound clinics, would help directly target, and address early interventions, for these infections.
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Affiliation(s)
- Lucy O. Attwood
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical SchoolMonash UniversityMelbourneAustralia
| | | | - Peter Higgs
- Burnet InstituteMelbourneAustralia
- Department of Public HealthLa Trobe UniversityMelbourneAustralia
| | - Olga Vujovic
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical SchoolMonash UniversityMelbourneAustralia
| | - Joseph S. Doyle
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical SchoolMonash UniversityMelbourneAustralia
- Burnet InstituteMelbourneAustralia
| | - Andrew J. Stewardson
- Department of Infectious Diseases, The Alfred Hospital and Central Clinical SchoolMonash UniversityMelbourneAustralia
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Tanrıkulu AB, Kaya H, Çatak Z. Elevated C-reactive protein/albumin ratio in patients with methamphetamine use disorder. Int J Psychiatry Clin Pract 2023; 27:351-358. [PMID: 37477597 DOI: 10.1080/13651501.2023.2237557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/09/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Methamphetamine use disorder causes significant crises, which have individual, familial, and social consequences. Identifying inflammatory biomarkers for methamphetamine use disorder may be useful for following the inflammatory status of patients in clinical assessment. In this study, we aimed to investigate whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), C-reactive protein/albumin ratio (CAR) and neutrophil/albumin ratio (NAR) levels can be used as inflammatory biomarkers in methamphetamine use disorder. METHODS The sample comprised 139 treatment-seeking participants who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for methamphetamine use disorder and 139 sociodemographically matched controls. Only hospitalised patients were included. An independent sample t-test, Pearson's correlation test, and binominal logistic regression analysis were performed. RESULTS CAR (p = 0.016) and NAR (p = 0.048) levels were significantly higher in individuals with methamphetamine use disorder when compared with healthy controls. The CAR level was found to be a significant predictor of group membership in regression analysis for methamphetamine use disorder. CONCLUSION CAR may be a potential inflammatory biomarker for patients with methamphetamine use disorder. CAR as a relatively easier-to-measure biomarker could be beneficial to follow the inflammatory status and treatment response of patients.
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Affiliation(s)
- Ali Baran Tanrıkulu
- Psychiatry, Elazığ Mental Health and Diseases Hospital, Turkey Elazığ, Turkey
| | - Hilal Kaya
- Psychiatry, Elazığ Mental Health and Diseases Hospital, Turkey Elazığ, Turkey
| | - Zekiye Çatak
- Department of Biochemistry, Health Sciences University Elazığ Fethi Sekin City Hospital, Central Laboratory, Elazig, Turkey
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Mantinieks D, Archer M, Schumann J, Drummer OH, Gerostamoulos D. Methylamphetamine toxicity and its involvement in death: A retrospective observational study of deaths reported to the Victorian Coroner, Australia. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00724-0. [PMID: 37792205 DOI: 10.1007/s12024-023-00724-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
A retrospective observational study of Victorian deaths involving MA between 2010 and 2019 was conducted to determine the prevalence and contribution of methylamphetamine (MA) toxicity to death in the absence of other factors. Demographics, autopsy findings, toxicology, and the cause of death were reviewed. Coronial cases were categorized into five groups: deaths due to MA toxicity in the absence of other factors (Group A1); deaths due to MA toxicity in the setting of other potentially contributing factors (Group A2); deaths due to MA toxicity in the setting of significant natural disease (Group B); deaths primarily due to multiple-drug toxicity (Group C); and deaths primarily due to natural causes (Group D). There were 506 deaths involving MA categorized into Group A1 (n = 1, 0.6%), Group A2 (n = 8, 1.6%), Group B (n = 28, 5.5%), Group C (n = 229, 45%), and Group D (n = 240, 47%). Significant natural disease was prevalent among deaths involving MA and mainly concerned forms of cardiovascular disease (n = 277, 55%). The MA concentration in the one death included in Group A1 was 2.1 mg/L. The median MA concentrations of Group A2 (1.6 mg/L) and Group B (0.5 mg/L) were significantly higher than Group C (0.2 mg/L) and Group D (0.2 mg/L). Additionally, many other toxicologically significant drugs were detected and mostly comprised of central nervous system depressants. Deaths due to MA toxicity in the absence of other factors were rare despite the greater availability of crystal MA in the Australian community. The study highlights the interpretative challenges of MA blood concentrations and the continuing harms of this drug in Australia.
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Affiliation(s)
- Dylan Mantinieks
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank 3006, Victoria, Australia.
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank 3006, Victoria, Australia.
| | - Melanie Archer
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
| | - Jennifer Schumann
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
| | - Olaf H Drummer
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
| | - Dimitri Gerostamoulos
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank 3006, Victoria, Australia
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Weber C, Smith JL, Soderstrom J, Burrows S, McCutcheon D, Oosthuizen F, Fatovich DM. Analytically confirmed illicit and novel psychoactive drug use in Western Australian emergency departments: initial results from the Emerging Drugs Network of Australia (EDNA). Clin Toxicol (Phila) 2023:1-9. [PMID: 37449677 DOI: 10.1080/15563650.2023.2229951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The burden of acute illicit drug use in Australia is largely unknown. Establishing a prospective drug surveillance system in emergency departments using analytical confirmation may facilitate the early identification of emerging drugs. We describe demographic data and acute toxicity patterns, stratified by analytical confirmation of illicit drugs and novel psychoactive substances, to emergency departments in Western Australia. METHODS Patients presenting with severe and/or unusual clinical features consistent with recreational drug toxicity were identified across five Western Australian emergency departments participating in the Emerging Drugs Network of Australia between April 2020 and December 2021. Demographic and toxicology patterns in patients with and without analytically confirmed illicit drugs/novel psychoactive substances from blood samples were collected during the emergency department presentation. RESULTS The cohort included 434 severe and/or unusual toxicology presentations; median age 33 years (first and third quartiles 25-40 years), 268 (61.8%) males. Any substance (illicit, novel psychoactive substance, pharmaceutical) was detected in 405 (93.3%) presentations. Illicit drugs/novel psychoactive substances were detected in 257 (59.2%) presentations, including 73 (28.3%) with more than one confirmed illicit drug/novel psychoactive substance. Frequent illicit drugs identified were metamfetamine (n = 201, 77.9%) and gamma-hydroxybutyrate (n = 30, 11.6%). Forty-eight novel psychoactive substances were detected within 43 (16.7%) presentations. Novel benzodiazepines were most frequently detected (n = 29, 60.4%). Frequent pharmaceuticals detected included diazepam (n = 100, 26.1%) and clonazepam (n = 40, 10.4%). One hundred and fifty-five (35.7%) presentations were discharged home and 56 (12.9%) were admitted to intensive care. Presentations with detected illicit drugs/novel psychoactive substances had a lower median intensive care length of stay compared to presentations without detected illicit drugs/novel psychoactive substances (32.6 h versus 50.8 h respectively, P < 0.001). CONCLUSIONS Integration of clinical and analytic data in patients with severe and/or unusual toxicology presentations via the Emerging Drugs Network of Australia provides insight into illicit drug/novel psychoactive substance use responsible for acute harm across Western Australian emergency departments.
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Affiliation(s)
- Courtney Weber
- Harry Perkins Institute of Medical Research, Centre for Clinical Research in Emergency Medicine, Perth, Australia
- East Metropolitan Health Service, Perth, Australia
| | - Jennifer L Smith
- Harry Perkins Institute of Medical Research, Centre for Clinical Research in Emergency Medicine, Perth, Australia
- East Metropolitan Health Service, Perth, Australia
| | - Jessamine Soderstrom
- Harry Perkins Institute of Medical Research, Centre for Clinical Research in Emergency Medicine, Perth, Australia
- Emergency Department, Royal Perth Hospital, Perth, Australia
- School of Medicine, The University of Western Australia, Perth, Australia
| | - Sally Burrows
- School of Medicine, The University of Western Australia, Perth, Australia
- Royal Perth Hospital Research Foundation, Perth, Australia
| | - David McCutcheon
- Harry Perkins Institute of Medical Research, Centre for Clinical Research in Emergency Medicine, Perth, Australia
- East Metropolitan Health Service, Perth, Australia
- Emergency Department, Royal Perth Hospital, Perth, Australia
- School of Medicine, The University of Western Australia, Perth, Australia
| | | | - Daniel M Fatovich
- Harry Perkins Institute of Medical Research, Centre for Clinical Research in Emergency Medicine, Perth, Australia
- East Metropolitan Health Service, Perth, Australia
- Emergency Department, Royal Perth Hospital, Perth, Australia
- School of Medicine, The University of Western Australia, Perth, Australia
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11
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Abdelsalam S, Livingston M, Quinn B, Agius PA, Ward B, Jamieson L, Dietze P. Correlates of poor oral health related quality of life in a cohort of people who use methamphetamine in Australia. BMC Oral Health 2023; 23:479. [PMID: 37443024 PMCID: PMC10339651 DOI: 10.1186/s12903-023-03201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES Methamphetamine use impacts oral health, but little is known about its impacts on oral health related quality of life (OHRQoL). In this study we examined OHRQoL in a cohort of people who use methamphetamine and assessed associations with sociodemographic, behavioural, psychosocial and dental service utilisation correlates. A secondary aim was to examine the relationship between methamphetamine route of administration and OHRQoL, to test whether smoking the drug is associated with reduced OHRQoL. METHODS Cross-sectional analysis was performed, using data from VMAX, a cohort of people who use methamphetamine at least monthly in Victoria, Australia (n = 194). Utilising the oral health impact profile (OHIP-14), we assessed three OHRQoL outcomes: OHIP-14 prevalence, OHIP-14 extent and OHIP-14 severity. Regression analyses examined associations between independent variables and the three OHIP-14 outcome measures. RESULTS A significant segment of the cohort (35%) reported poor OHRQoL. Overall, no statistically significant association was detected between methamphetamine route of administration and the three OHIP-14 outcomes. Participants living in rural areas, with moderate-to-severe self-reported depression and with methamphetamine dependence had significantly worse OHRQoL levels, which persisted after adjusting for other covariates. CONCLUSION Overall, VMAX cohort participants reported reduced OHRQoL levels. Our findings highlight the need for upstream interventions to improve the OHRQoL of people who use methamphetamine, with specific focus on those living in rural locations. Further research on the links between OHRQoL and mental health among people who use methamphetamine is required.
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Affiliation(s)
- Shady Abdelsalam
- National Drug Research Institute (NDRI), Faculty of Health Sciences, Curtin University, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
| | - Michael Livingston
- National Drug Research Institute (NDRI), Faculty of Health Sciences, Curtin University, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC 3086 Australia
| | - Brendan Quinn
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia
| | - Paul A Agius
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia
- Faculty of Health, Deakin University, Burwood, VIC 3125 Australia
| | - Bernadette Ward
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Monash University School of Rural Health, 26 Mercy St, Bendigo, VIC 3550 Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide Dental School, Adelaide, SA 5005 Australia
| | - Paul Dietze
- National Drug Research Institute (NDRI), Faculty of Health Sciences, Curtin University, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia
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12
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Smucny J, Maddock RJ. Spectroscopic meta-analyses reveal novel metabolite profiles across methamphetamine and cocaine substance use disorder. Drug Alcohol Depend 2023; 248:109900. [PMID: 37148676 PMCID: PMC11187716 DOI: 10.1016/j.drugalcdep.2023.109900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Although proton magnetic resonance spectroscopy (MRS) has been used to study metabolite alterations in stimulant (methamphetamine and cocaine) substance use disorders (SUDs) for over 25 years, data-driven consensus regarding the nature and magnitude of these alterations is lacking. METHOD In this meta-analysis, we examined associations between SUD and regional metabolites (N-acetyl aspartate (NAA), choline, myo-inositol, creatine, glutamate, and glutamate+glutamine (glx)) in the medial prefrontal cortex (mPFC), frontal white matter (FWM), occipital cortex, and basal ganglia as measured by 1 H-MRS. We also examined moderating effects of MRS acquisition parameters (echo time (TE), field strength), data quality (coefficient of variation (COV)), and demographic/clinical variables. RESULTS A MEDLINE search revealed 28 articles that met meta-analytic criteria. Significant effects included lower mPFC NAA, higher mPFC myo-inositol, and lower mPFC creatine in SUD relative to people without SUD. mPFC NAA effects were moderated by TE, with larger effects at longer TEs. For choline, although no group effects were observed, effect sizes in the mPFC were related to MRS technical indicators (field strength, COV). No effects of age, sex, primary drug of use (methamphetamine vs. cocaine), duration of use, or duration of abstinence were observed. Evidence for moderating effects of TE and COV may have implications for future MRS studies in SUDs. CONCLUSIONS The observed metabolite profile in methamphetamine and cocaine SUD (lower NAA and creatine with higher myo-inositol) parallels that observed in Alzheimer's disease and mild cognitive impairment, suggesting these drugs are associated with neurometabolic differences similar to those characterizing these neurodegenerative conditions.
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Affiliation(s)
- Jason Smucny
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, USA.
| | - Richard J Maddock
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, USA
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13
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Yen CF, Chou WP, Hsu CY, Wu HC, Wang PW. Effects of heart rate variability biofeedback (HRVBFB) on sleep quality and depression among methamphetamine users. J Psychiatr Res 2023; 162:132-139. [PMID: 37149922 DOI: 10.1016/j.jpsychires.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/29/2023] [Accepted: 05/01/2023] [Indexed: 05/09/2023]
Abstract
Methamphetamine is garnering concern due to its increasing use worldwide. Depression and sleep quality are major mental health issues in substance users. Heart rate variability biofeedback (HRVBFB) has shown promising results in terms of reducing depression and increasing sleep quality. The present study aimed to explore the effects of HRVBFB on these two issues in methamphetamine users. Sixty-one methamphetamine users were enrolled and allocated randomly into a treatment as usual (TAU) group and a HRVBFB plus TAU group. The levels of depressive symptoms and sleep quality were assessed at intake, end of the intervention, and end of follow-up. Compared with baseline, the levels of depressive symptoms and poor sleep quality were decreased at the end of the intervention and follow-up in the HRVBFB group. The HRVBFB group exhibited a greater decrease in depressive symptoms and a better improvement in sleep quality than the TAU group. The associations of HRV indices with levels of depressive symptoms and poor sleep quality were different in the two groups. Our results showed that HRVBFB is a promising intervention for reducing depressive symptoms and improving sleep quality in methamphetamine users. The benefits with respect to depressive symptoms and poor sleep quality can extend beyond the end of HRVBFB intervention.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan
| | - Wei-Po Chou
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan
| | - Chih-Yao Hsu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan.
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14
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Boden JM, Foulds JA, Cantal C, Jones R, Dent J, Mora K, Goulding J. Predictors of methamphetamine use in a longitudinal birth cohort. Addict Behav 2023; 144:107714. [PMID: 37060881 DOI: 10.1016/j.addbeh.2023.107714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Identifying predictors of methamphetamine use can inform population prevention strategies. METHODS Participants (n = 1265) born in Christchurch, New Zealand were followed from birth to age 40. Methamphetamine outcomes (any use since the last interview, and regular use, defined as any period of at least weekly use) were ascertained by self-report at six interviews from age 18 to 40. Predictors with plausible associations with methamphetamine use were extracted from the study database. These were grouped into early predictors (age 0-16), comprising childhood, familial and individual characteristics; and later time-dynamic correlates of methamphetamine use in adulthood (ages 16-40). Generalised estimating equation models were fitted to identify predictors of methamphetamine use outcomes. RESULTS In adjusted models, paternal overprotectiveness and childhood anxious / withdrawn behavior were associated with any use of methamphetamine, but not regular use. Conversely, childhood conduct problems and parental illicit drug were associated with regular use but not any use. Male sex, high novelty seeking and deviant peer affiliations were associated with both any use and regular use in adjusted models. The strongest correlates of methamphetamine use in adulthood were unemployment, life stress and other substance use disorders (cannabis, nicotine, and alcohol). CONCLUSION Markers of externalizing problems in childhood and adolescence (conduct problems, high novelty seeking, parental illicit substance use, and deviant peer affiliations) are the strongest predictors of regular methamphetamine use in adulthood.
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Affiliation(s)
- Joseph M Boden
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago Christchurch, New Zealand.
| | - James A Foulds
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Clara Cantal
- Evidence Based Policing Centre, New Zealand Police, Wellington, New Zealand
| | - Ryan Jones
- Evidence Based Policing Centre, New Zealand Police, Wellington, New Zealand
| | - Jess Dent
- Evidence Based Policing Centre, New Zealand Police, Wellington, New Zealand
| | - Kate Mora
- Evidence Based Policing Centre, New Zealand Police, Wellington, New Zealand
| | - Jane Goulding
- Evidence Based Policing Centre, New Zealand Police, Wellington, New Zealand
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15
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Tardelli VS, Johnstone S, Xu B, Kim S, K. Kim H, Gratzer D, George TP, Le Foll B, Castle DJ. Marked Increase in Amphetamine-Related Emergency Department Visits and Inpatient Admissions in Toronto, Canada, 2014-2021. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:249-256. [PMID: 36809914 PMCID: PMC10037744 DOI: 10.1177/07067437221125302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We report emergency department and inpatient amphetamine-related trends focusing on co-occurring substance use and psychiatric diagnoses at the Centre for Addiction and Mental Health, the largest mental health teaching hospital in Canada. METHODS We describe yearly trends in amphetamine-related Centre for Addiction and Mental Health emergency department visits and inpatient admissions out of all emergency department visits and inpatient admissions between 2014 and 2021, along with proportions of concurrent substance-related admissions and mental/psychotic disorders emergency department visits and inpatient admissions among amphetamine-related contacts; joinpoint regression analyses assessed changes in amphetamine-related emergency department visits and inpatient admissions. RESULTS Amphetamine-related emergency department visits rose from 1.5% in 2014 to 8.3% in 2021, with a peak of 9.9% in 2020. Amphetamine-related inpatient admissions rose from 2.0% to 8.8% in 2021, with a peak of 8.9% in 2020. Significant increasing trends in the percentage of amphetamine-related emergency department visits happened especially between the second and the fourth quarter of 2014 (quarterly percent change = + 71.4, P <0.01). Similarly, the percentage of amphetamine-related inpatient admissions increased mostly between the second quarter of 2014 and the third quarter of 2015 (quarterly percent change = + 32.6, P <0.01). The proportion of concurrent opioid-related contacts among amphetamine-related emergency department visits and inpatient admission increased markedly between 2014 and 2021; psychotic disorders in amphetamine-related inpatient admissions more than doubled from 2015 to 2021. DISCUSSION Prevalence of amphetamine use, mostly from methamphetamine, has been increasing in Toronto as have co-occurring psychiatric disorders and opioid use. Our findings highlight the need for increases in accessible efficacious treatments for complex populations with polysubstance use and co-occurring disorders.
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Affiliation(s)
- Vitor S. Tardelli
- Centre for Complex Interventions, Centre for Addiction and Mental
Health, Toronto, Canada
- Departamento de Psiquiatria, Universidade Federal de Sao
Paulo, Sao Paulo, Brazil
- Translational Addiction Research Laboratory, Centre for Addiction and Mental
Health, Toronto, Canada
| | - Samantha Johnstone
- Centre for Complex Interventions, Centre for Addiction and Mental
Health, Toronto, Canada
| | - Bin Xu
- CAMH Reporting and Analytics/Performance Improvement, Toronto,
Canada
| | - Soyeon Kim
- Waypoint Research Institute, Waypoint Centre for Mental Health
Care, Penetanguishene, Canada
- Psychiatry and Behavioural
Neurosciences, McMaster University, Hamilton, Canada
| | - Helena K. Kim
- Department of Psychiatry, University of Toronto, Toronto,
Canada
| | - David Gratzer
- Department of Psychiatry, University of Toronto, Toronto,
Canada
- Centre for Addiction and Mental
Health, Toronto, ON, Canada
| | - Tony P. George
- Centre for Complex Interventions, Centre for Addiction and Mental
Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto,
Canada
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental
Health, Toronto, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health
Care, Penetanguishene, Canada
| | - David J. Castle
- Centre for Complex Interventions, Centre for Addiction and Mental
Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto,
Canada
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16
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Anderson AC, Robinson AH, Giddens E, Hartshorn B, Allan E, Rowe C, Lawrence T, Chong TTJ, Lubman DI, Verdejo-Garcia A. Proof-of-concept trial of Goal Management Training + to improve executive functions and treatment outcomes in methamphetamine use disorder. Drug Alcohol Depend 2023; 246:109846. [PMID: 37004463 DOI: 10.1016/j.drugalcdep.2023.109846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/30/2023] [Accepted: 03/13/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Deficits in executive function are common in methamphetamine use disorder (MUD), likely contributing to difficulties in sustained treatment success. Cognitive remediation interventions are designed to treat such deficits but have not been adapted to the needs of people with MUD. This study presents a proof-of-concept trial to evaluate a new cognitive remediation program for MUD, Goal Management Training+ (GMT+). METHODS This was a cluster-randomised crossover trial comparing GMT+ with a psychoeducation-based control (Brain Health Workshop; BHW). GMT+ is a therapist-administered group-based cognitive remediation for executive dysfunction comprising four 90-minute weekly sessions and daily journal activities. BHW is a lifestyle psychoeducation program matched to GMT+ for therapist involvement, format, and duration. Participants (n = 36; GMT n = 17; BHW n = 19) were recruited from therapeutic communities in Victoria, Australia. Primary outcomes included intervention acceptability, feasibility, and improvements in self-reported executive function. Secondary outcomes included cognitive tests of executive function, severity of methamphetamine dependence, craving, and quality of life. We performed mixed linear modelling and calculated Hedges' g effect sizes. RESULTS GMT+ participant ratings and program retention indicated high acceptability. There was no difference between GMT+ and BHW on self-reported executive function (g = 0.06). Cognitive tasks suggested benefits of GMT+ on information gathering (g = 0.88) and delay-discounting (g = 0.80). Severity of methamphetamine dependence decreased more in GMT+ (g = 1.47). CONCLUSIONS GMT+ was well-accepted but did not improve self-reported executive functioning. Secondary outcomes suggested GMT+ was beneficial for objective cognitive performance and severity of dependence.
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Affiliation(s)
- Alexandra C Anderson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Addiction Research Centre, Monash University, Victoria, Australia
| | - Alex H Robinson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Addiction Research Centre, Monash University, Victoria, Australia
| | - Emily Giddens
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Breanna Hartshorn
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Eric Allan
- Odyssey House Victoria, Melbourne, Victoria, Australia
| | - Carol Rowe
- Odyssey House Victoria, Melbourne, Victoria, Australia
| | | | - Trevor T-J Chong
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Victoria, Australia; Monash Addiction Research Centre, Monash University, Victoria, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Addiction Research Centre, Monash University, Victoria, Australia.
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17
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Brett J, Knock E, Korthuis PT, Liknaitzky P, Murnane KS, Nicholas CR, Patterson JC, Stauffer CS. Exploring psilocybin-assisted psychotherapy in the treatment of methamphetamine use disorder. Front Psychiatry 2023; 14:1123424. [PMID: 36998623 PMCID: PMC10043240 DOI: 10.3389/fpsyt.2023.1123424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
Methamphetamine use disorder is a chronic relapsing condition associated with substantial mental, physical, and social harms and increasing rates of mortality. Contingency management and psychotherapy interventions are the mainstays of treatment but are modestly effective with high relapse rates, while pharmacological treatments have shown little to no efficacy. Psilocybin-assisted psychotherapy is emerging as a promising treatment for a range of difficult-to-treat conditions, including substance use disorders; however, no studies have yet been published looking at psilocybin-assisted psychotherapy in the treatment of methamphetamine use disorder. Here we review the rationale for psilocybin-assisted psychotherapy as a potential treatment for this indication, and describe practical considerations based on our early experience designing and implementing four separate clinical trials of psilocybin-assisted psychotherapy for methamphetamine use disorder.
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Affiliation(s)
- Jonathan Brett
- Department of Clinical Pharmacology, St. Vincent’s Hospital, Sydney, NSW, Australia
- School of Population Health, Medicines Intelligence Centre of Research Excellence, University of New South Wales, Sydney, NSW, Australia
| | - Elizabeth Knock
- Alcohol and Drug Service, St. Vincent’s Hospital, Sydney, NSW, Australia
| | - P. Todd Korthuis
- Section of Addiction Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Paul Liknaitzky
- Department of Psychiatry, School of Clinical Sciences, Monash University, Caulfield, VIC, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Caulfield, VIC, Australia
| | - Kevin S. Murnane
- Louisiana Addiction Research Center, Department of Pharmacology, Toxicology & Neuroscience, Shreveport, LA, United States
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health, Shreveport, LA, United States
| | - Christopher R. Nicholas
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI, United States
| | - James C. Patterson
- Louisiana Addiction Research Center, Department of Pharmacology, Toxicology & Neuroscience, Shreveport, LA, United States
- Department of Psychiatry and Behavioral Medicine, Louisiana State University Health, Shreveport, LA, United States
| | - Christopher S. Stauffer
- Department of Mental Health, Veterans Affairs Portland Health Care System, Portland, OR, United States
- Social Neuroscience and Psychotherapy Lab, Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- *Correspondence: Christopher S. Stauffer,
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18
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Carter G, Spittal MJ, Glowacki L, Gerostamoulos D, Dietze P, Sinclair B, Arunogiri S, Berk M, Lubman DI, Manning V, Higgs P, Quinn B, Baker A, Dean OM, Turner A, McKetin R. Diagnostic accuracy for self-reported methamphetamine use versus oral fluid test as the reference standard in a methamphetamine-dependent intervention trial population. Addiction 2023; 118:470-479. [PMID: 36367075 PMCID: PMC10952224 DOI: 10.1111/add.16085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022]
Abstract
AIMS Treatment of methamphetamine dependence requires monitoring of recent use or abstinence. Self-report is commonly used for routine monitoring, but the accuracy of self-report is not established. For the treating clinician, the key accuracy statistic is the negative predictive value (NPV). The study aim was to estimate the NPV of self-reported non-use of methamphetamine compared with an oral fluid reference standard. DESIGN, SETTING AND PARTICIPANTS This study was a secondary (subgroup) analysis from a randomized controlled pharmacotherapy trial. Three Australian outpatient addiction services took part. Particpants were 139 people dependent on methamphetamine. MEASUREMENTS Weekly oral fluid samples over 12 weeks to determine methamphetamine (and amphetamine) concentrations were used as the reference standard. Self-report of any methamphetamine use in the previous 7 days by the time-line follow-back method was the index test. Standard diagnostic accuracy statistics were calculated for all available paired episodes (n = 1134). Three NPV values were calculated: unadjusted NPV and NPV adjusted for clustering of observations through logistic regression and generalized estimating equation (GEE). We also calculated the NPVs for a range of prevalence rates of methamphetamine use, for the calculated levels of sensitivity and specificity. FINDINGS Sensitivity was 96.4% [95% confidence interval (CI) = 95-97.5], specificity was 63.7% (95% CI = 57.3-69.8) and positive predictive value (PPV) was 90.8% (95% CI = 88.8-92.6). The unadjusted NPV was 82.7% (95% CI = 76.5-87.9), adjusted NPV by logistic regression 82.7% (95% CI = 73.9-91.5) and GEE 76.8% (95% CI = 66.8-86.8). At a methamphetamine use prevalence of 5%, the estimated NPV would be 99.7% (95% CI = 99.6-99.9) and at 95% prevalence, 48.2% (95% CI = 39.6-57.0). CONCLUSIONS Self-report of no recent methamphetamine use appears to be sufficiently accurate to be clinically useful at the expected prevalence rates of methamphetamine use in clinical treatment settings. If generalizable to clinical settings, where these tests are routinely conducted, this may permit a reduction in the frequency and cost of oral fluid assays.
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Affiliation(s)
- Gregory Carter
- College of Health, Medicine and Wellbeing, School of Medicine and Public HealthUniversity of NewcastleCallaghanAustralia
| | - Matthew J. Spittal
- Melbourne School of Population and Global HealthUniversity of MelbourneAustralia
| | - Linda Glowacki
- Victorian Institute of Forensic MedicineSouthbankVictoriaAustralia
| | | | - Paul Dietze
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- National Drug Research Institute and enable InstituteCurtin UniversityMelbourneAustralia
| | | | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health SciencesMonash UniversityAustralia
| | - Michael Berk
- Deakin UniversityIMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon HealthGeelongAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneAustralia
| | | | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Faculty of Medicine, Nursing and Health SciencesMonash UniversityAustralia
- Turning Point, Eastern HealthRichmondAustralia
| | - Peter Higgs
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- Department of Public HealthLa Trobe UniversityBundooraAustralia
| | - Brendan Quinn
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- Australian Institute of Family StudiesMelbourneAustralia
| | - Amanda Baker
- College of Health, Medicine and Wellbeing, School of Medicine and Public HealthUniversity of NewcastleCallaghanAustralia
| | - Olivia M. Dean
- Deakin UniversityIMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon HealthGeelongAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneAustralia
| | - Alyna Turner
- Deakin UniversityIMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon HealthGeelongAustralia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSWSydneyAustralia
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19
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Schumann JL, Sarkar R, Grbic M, Drummer OH, Gerostamoulos D, Iles L, Bassed R. Changing trends and characteristics of one punch deaths in Australia (2012-2018). Forensic Sci Int 2023; 345:111621. [PMID: 36878145 DOI: 10.1016/j.forsciint.2023.111621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 12/22/2022] [Accepted: 02/25/2023] [Indexed: 03/02/2023]
Abstract
One-punch assaults also known as 'coward punches', are characterised by a single severe blow to the head causing the victim to lose consciousness, resulting in a secondary impact between the head and surrounding environment. Such impacts may result in brain injury leading to fatality or permanent neurological impairment. In a previous publication, there were 90 one punch deaths around Australia between 2000 and 2012, mostly involving young men drinking alcohol at a licensed venue at the weekend. This prompted a surge of public education and awareness campaigns around Australia, in addition to regulatory and legislative changes aimed at curbing social violence. This retrospective descriptive study aimed to examine one punch deaths since 2012 in Australia to determine if there has been a decrease in deaths, and whether the demographics and circumstances of these deaths have changed. A search of the National Coronial Information System was undertaken for all closed coronial cases between 1 January 2012 and 31 December 2018. Additional information was collected from medicolegal reports including toxicology, pathology and coronial findings. There were 80 one punch fatalities in Australia, almost exclusively involving males. The median age was 43.5 (range 18-71) years and there was a decreasing trend in the number of deaths annually. Most fatal assaults occurred in the state of New South Wales (28.8%) followed by Queensland (23.8%), and in metropolitan locations (64.6%) rather than regional areas (35.4%). Alcohol was the most commonly detected drug, found in 47 cases of the 71 cases where toxicology results were available (66%), with a median concentration of 0.14 and 0.19 g/100 mL in antemortem and postmortem samples, respectively (range 0.005-0.32 g/100 mL). Five deaths reported methylamphetamine, with THC detected in 21.1% of cases. Assaults more commonly occurred on a footpath or roadside (41.3%), followed by a home or dwelling (32.5%). 8.8% of assaults occurred inside hotels, bars or other licenced venues. Most transpired on a weekday, which differed from the pre-2012 period when these assaults occurred mainly on the weekend. While some trends are positive, there has been a shift in the victim demographic as well as the typical environment for fatal one punch assaults, highlighting the importance of public health surveillance in providing a current evidence base to inform policy and practice.
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Affiliation(s)
- Jennifer L Schumann
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia; Monash Addiction Research Centre, Victoria, Australia.
| | - Reena Sarkar
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Marko Grbic
- Victorian Institute of Forensic Medicine, Victoria, Australia
| | - Olaf H Drummer
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Dimitri Gerostamoulos
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Linda Iles
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
| | - Richard Bassed
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Monash University, Victoria, Australia
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Clifford B, Van Gordon K, Magee F, Malone V, Siefried KJ, Graham D, Ezard N. "There's a big tag on my head": exploring barriers to treatment seeking with women who use methamphetamine in Sydney, Australia. BMC Health Serv Res 2023; 23:162. [PMID: 36793060 PMCID: PMC9933255 DOI: 10.1186/s12913-023-09125-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Australia has a high prevalence of regular use of methamphetamine. While half of people who use methamphetamine regularly are women, they make up only one third of people seeking treatment for methamphetamine use disorder. There is a lack of qualitative research into the facilitators and barriers to treatment for women who use methamphetamine regularly. The study seeks a better understanding of the experiences and treatment preferences of women who use methamphetamine, to inform person-centred changes in practice and policy that break down barriers to treatment. METHODS We conducted semi-structured interviews with 11 women who frequently use methamphetamine (at least once a week), and who are not engaged in treatment. Women were recruited from health services surrounding a stimulant treatment centre at an inner-city hospital. Participants were asked about their methapmhetamine use and health service needs and preferences. Thematic analysis was completed using Nvivo® software. RESULTS Three themes were developed from participants' responses around experiences of regular methamphetamine use and treatment needs: 1. Resistance of stigmatised identity including dependence; 2. Interpersonal violence; 3. Institutionalised stigma. A fourth set of themes on service delivery preferences were also elicited, including continuity of care, integrated health care, and provision of non-judgmental services. CONCLUSION Gender-inclusive health care services for people who use methamphetamine should actively work to address stigma, support a relational approach to assessment and treatment, and seek to provide structurally competent health care that is trauma and violence informed, and integrated with other services. Findings may also have application for substance use disorders other than methamphetamine.
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Affiliation(s)
- Brendan Clifford
- Alcohol & Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia. .,National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales, Australia. .,Drug and Alcohol Clinical Research and Improvement Network, Sydney, New South Wales, Australia. .,National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, Australia.
| | - Kate Van Gordon
- Victor Medical Centre, Victor Harbor, South Australia Australia
| | - Fiona Magee
- grid.477714.60000 0004 0587 919XSouth Eastern Sydney Local Health District, Sydney, New South Wales Australia
| | - Victoria Malone
- grid.437825.f0000 0000 9119 2677Alcohol & Drug Service, St Vincent’s Hospital Sydney, Sydney, New South Wales Australia
| | - Krista J. Siefried
- grid.437825.f0000 0000 9119 2677Alcohol & Drug Service, St Vincent’s Hospital Sydney, Sydney, New South Wales Australia ,grid.508539.2National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - Duncan Graham
- grid.508539.2National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales Australia
| | - Nadine Ezard
- grid.437825.f0000 0000 9119 2677Alcohol & Drug Service, St Vincent’s Hospital Sydney, Sydney, New South Wales Australia ,grid.508539.2National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales Australia ,Drug and Alcohol Clinical Research and Improvement Network, Sydney, New South Wales Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, Australia
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Sunderland M, Kershaw S, Ward C, Bryant Z, Teesson L, Whittle R, Paton E, Charnley JL, Skehan J. Media reporting on alcohol and other drugs in Australia and the Mindframe guidelines: Baseline data. Drug Alcohol Rev 2023. [PMID: 36798029 DOI: 10.1111/dar.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/24/2022] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
INTRODUCTION The aim of this study was to generate a baseline database of print media reporting on alcohol and other drug (AOD) issues prior to the release of the Mindframe guidelines in March 2019. Specifically, to: (i) describe the content associated with media entries that focus on AOD use in Australian news media; (ii) determine how the media entries compare to several domains associated with recently developed Mindframe guidelines for publicly reporting on AOD; and (iii) identify content factors associated with different scores. METHODS Media entries between July 2016 and June 2017 were searched for key AOD-related terms using the Australian and New Zealand Newsstream database. Two coding schemes were developed to rate a stratified sample of 50% of the media entries against the Mindframe guidelines. Associations between content and total comparison scores were determined using linear regression models. RESULTS Detailed coding of the 2007 articles identified as relevant for the current study indicated that a majority (67%) were focused on one of three substances: alcohol, cannabis or methamphetamine. Most of the entries were either law enforcement (22%) or criminal justice related (19%). Entries that focused on methamphetamine scored significantly lower than entries on alcohol when compared to the Mindframe guidelines, similarly entries focused on crime/justice-related topics scored significantly lower than entries focused on positive outcomes. DISCUSSION AND CONCLUSIONS A disproportionate number of print media entries, particularly those related methamphetamine use, focused on crime or justice-related topics, potentially further contributing to stigma, and emphasising the legal consequences of AOD use.
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Affiliation(s)
- Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Stephanie Kershaw
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Caitlin Ward
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Zachary Bryant
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lily Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Rebecca Whittle
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Elizabeth Paton
- Everymind, Hunter New England Health, Newcastle, Australia.,College of Human and Social Futures, University of Newcastle, Newcastle, Australia
| | - Janine L Charnley
- Everymind, Hunter New England Health, Newcastle, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Jaelea Skehan
- Everymind, Hunter New England Health, Newcastle, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
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Black E, Mammen K, Deacon RM, Ezard N, Mills L, Dunlop AJ, Montebello M, Reid D, Childs S, Bruno R, Shakeshaft A, Siefried KJ, Farrell M, Holmes J, Lintzeris N. Health and social characteristics of clients reporting amphetamine type substance use at entry to public alcohol and other drug services in New South Wales, Australia, 2016-2019. Drug Alcohol Rev 2023; 42:389-400. [PMID: 36524444 PMCID: PMC10107800 DOI: 10.1111/dar.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Amphetamine type substances (ATS) are commonly used by Australian alcohol and other drug service entrants. We describe demographic characteristics, patterns of ATS and other substance use, health and social conditions among clients entering New South Wales (NSW) public alcohol and other drug services. METHODS Retrospective cohort of 13,864 records across six health districts (2016-2019) for clients seeking substance use treatment. These districts service approximately 44% of the NSW population aged 15 years and over. Multivariate analysis was conducted on a subsample for whom full data were available (N = 9981). Data included NSW Minimum Data Set for drug and alcohol treatment services and Australian Treatment Outcomes Profile items. RESULTS Over the preceding 4 weeks, 77% (n = 10,610) of clients (N = 13,864) reported no recent ATS use, 15% (n = 2109) reported 'low frequency' (1-12 days) and 8% (n = 1145) 'high frequency' (13-28 days) use. ATS use was most common among people attending for ATS or opioids as primary drug of concern. A multinomial regression (N = 9981) identified that clients reporting recent arrest (aOR 1.74, 95% CI 1.36, 2.24), higher cannabis use frequency (aOR 1.01, 95% CI 1.00, 1.02), lower opioid use frequency (aOR 0.98, 95% CI 0.97, 0.99) and poorer quality of life (aOR 0.91, 95% CI 0.86, 0.97) were more likely to report 'high frequency' rather than 'low frequency' ATS use. DISCUSSION AND CONCLUSIONS People who use ATS experience health and social issues that may require targeted responses. These should be integrated across all services, not only for clients with ATS as principal drug of concern.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
| | - Rachel M. Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Adrian J. Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Clinical Services, Hunter New England Local Health DistrictNewcastleAustralia
- School of Medicine and Public HealthCollege of Health & Wellbeing, University of NewcastleNewcastleAustralia
- HMRI Healthcare Transformation Research ProgramNewcastleAustralia
| | - Mark Montebello
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, North Sydney Local Health DistrictSydneyAustralia
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Central Coast Local Health DistrictGosfordAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | | | - Krista J. Siefried
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Jennifer Holmes
- Centre for Alcohol and other Drugs, NSW Ministry of HealthSydneyAustralia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
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Galanter M, White WL, Hunter B. Narcotics Anonymous members in recovery from methamphetamine use disorder. Am J Addict 2023; 32:54-59. [PMID: 36428292 PMCID: PMC10099615 DOI: 10.1111/ajad.13362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Methamphetamine use disorder (MUD) is a major public health problem, but there are no evidence-based, best-practice, pharmacologic, or behavioral treatments for it. Narcotics Anonymous (NA) may provide an option for referral for such patients. METHODS Two waves of surveys were sent to a sample of NA members to evaluate demographic, drug use, and NA-related issues. Of 4445 responses received from US residents, 647 listed themselves as abstinent from their worst drug problem, methamphetamine. Twelve possible sources of support were scored by these latter respondents for how important each was for their own recovery. RESULTS Methamphetamine respondents were longstanding NA members, with their first NA meeting 30.2 years ago, 84.3% having served as sponsors for other members, and with little current craving (0.65 out of 10). Although now abstinent for an average of 13.4 years, at some point over the course of the membership, 47.4% had experienced a relapse, for an average of 16.7 months. In a factor analysis of resources scored, 29.6% of the variance fell under NA social and 29.2% spiritual; and 11.8% under outside professional support. DISCUSSION AND CONCLUSIONS NA served as a resource for supporting abstinence for some members with MUD. They scored social resources of NA support higher than both spiritual and outside institutional ones. SCIENTIFIC SIGNIFICANCE NA can serve as a community-based resource for MUD. Determining the nature of recovery that members with MUD have in NA can be useful for further research of socially grounded support for recovery in substance use disorders.
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Affiliation(s)
- Marc Galanter
- Department of Psychiatry, New York University School of Medicine, New York, New York, USA
| | - William L White
- Research Division, Chestnut Health Systems, Punta Gorda, Florida, USA
| | - Brooke Hunter
- Research Division, Chestnut Health Systems, Normal, Illinois, USA
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24
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Jones CM, Han B, Seth P, Baldwin G, Compton WM. Increases in methamphetamine injection among treatment admissions in the U.S. Addict Behav 2023; 136:107492. [PMID: 36156454 PMCID: PMC9809156 DOI: 10.1016/j.addbeh.2022.107492] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/18/2022] [Accepted: 09/09/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Prior research indicates rising methamphetamine use and harms in the U.S., potentially related to increases in methamphetamine injection. To date, research on trends and correlates of methamphetamine injection is limited. METHODS Analysis of trends and correlates of methamphetamine injection among treatment admissions among persons aged ≥ 12 whose primary substance of use at admission is methamphetamine. Data are from the Treatment Episode Data Set. Analyses includes descriptive statistics, trend analyses, and multilevel multivariable logistic regression. RESULTS Primary methamphetamine treatment admissions increased from 138,379 in 2010 to 201,021 in 2019. Among primary methamphetamine admissions, injection as the usual route of use increased from 24,821 (18.0 % of admissions) in 2010 to 55,951 (28.2 % of admissions) in 2019. Characteristics associated with increased adjusted odds of reporting methamphetamine injection included: males (aOR = 1.13, 95 % CI = 1.10-1.15); admission age 25-34 years (aOR = 1.23, 95 % CI = 1.19-1.28) and 35-44 years (aOR = 1.12, 95 % CI = 1.08-1.17) compared to age 18-24; dependent living (aOR = 1.33, 95 % CI = 1.29-1.37) and homelessness (aOR = 1.58, 95 % CI = 1.54-1.63) compared to independent living; part-time employment (aOR = 1.08, 95 % CI = 1.02-1.14), unemployment (aOR = 1.39, 95 % CI = 1.34-1.44) and not in labor force (aOR = 1.43, 95 % CI = 1.37-1.49) compared to full-time employment; one to ≥ four prior treatment admissions (aORs ranging from 1.19 to 1.94) compared to no prior admissions; also reporting use of cocaine (aOR = 1.10, 95 % CI = 1.05-1.16), heroin (aOR = 3.52, 95 % CI = 3.40-3.66), prescription opioids (aOR = 1.61, 95 % CI = 1.54-1.67), or benzodiazepines (aOR = 1.42, 95 % CI = 1.32-1.52) at treatment admission. CONCLUSIONS Findings lend further evidence to a resurgence of methamphetamine use that is intertwined with the ongoing opioid crisis in the U.S. Efforts to expand evidence-based prevention, treatment, and response efforts, particularly to populations at highest risk, are urgently needed.
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Affiliation(s)
- Christopher M Jones
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
| | - Puja Seth
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Grant Baldwin
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
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25
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Kerry GL, Ross KE, Wright JL, Walker GS. A Review of Methods Used to Detect Methamphetamine from Indoor Air and Textiles in Confined Spaces. TOXICS 2022; 10:710. [PMID: 36422918 PMCID: PMC9695000 DOI: 10.3390/toxics10110710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Methamphetamine manufacture, use, and the resulting contamination is a significant issue that affects public health, the environment, and the economy. Third-hand exposure to methamphetamine can result in adverse health risks for individuals and first responders. Such exposures can result from the inhalation of airborne residues or from contact with contaminated objects. This review was conducted to determine the current methods used for methamphetamine extraction from indoor air and porous fabric materials. Dynamic solid phase microextraction (SPME) and sorbent sampling tubes have been applied to extract airborne methamphetamine residues from contaminated properties. SPME and solvent extraction have been applied to sample clothing and textiles for methamphetamine detection. This review demonstrates that there is limited literature on the detection of methamphetamine from indoor air and clothing. Supplementary and consistent methods to detect methamphetamine from air and porous surfaces should be developed and published to allow better assessment of the environmental risk to public health caused by third-hand exposure to methamphetamine.
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Affiliation(s)
- Gemma L. Kerry
- Physical and Molecular Sciences, College of Science and Engineering, Flinders University, Adelaide 5042, Australia
| | - Kirstin E. Ross
- Environmental Health, College of Science and Engineering, Flinders University, Adelaide 5042, Australia
| | - Jackie L. Wright
- Environmental Health, College of Science and Engineering, Flinders University, Adelaide 5042, Australia
- Environmental Risk Sciences Pty Ltd., Carlingford Court, P.O. Box 2537, Sydney 2118, Australia
| | - G. Stewart Walker
- Physical and Molecular Sciences, College of Science and Engineering, Flinders University, Adelaide 5042, Australia
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Quinn CA, Walter ZC, de Andrade D, Dingle G, Haslam C, Hides L. Controlled Trial Examining the Strength-Based Grit Wellbeing and Self-Regulation Program for Young People in Residential Settings for Substance Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13835. [PMID: 36360714 PMCID: PMC9657698 DOI: 10.3390/ijerph192113835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
This cohort-controlled trial examined whether the 12-session Grit Wellbeing and Self-regulation Program enhanced the treatment outcomes of young people accessing residential alcohol and other drug (AOD) treatment. Grit focuses on increasing wellbeing and reducing substance use and mental health problems by building self-regulation skills, strengths, social connections, and health behaviours. Participants were 194 (66% male, Mage 27.40) young people (aged 18-35 years) accessing a six-week residential treatment program for substance use. Participants received standard treatment, or standard treatment plus Grit (two sessions/week for six weeks). The primary outcome was substance use, measured as: (i) global substance use and (ii) alcohol, methamphetamine, and cannabis use involvement. Secondary outcomes included wellbeing, depression, anxiety, and vocational engagement. Participants were assessed at baseline, and 6-weeks (secondary outcomes only), 3-months, 6-months, and 12-months post-program enrolment. Results revealed that both groups showed a significant improvement in all outcomes at three months, and improvements were maintained at 6- and 12-month follow-ups. The Grit group had a larger reduction in methamphetamine and cannabis use involvement compared to the control group. This study presents promising evidence that a six-week residential program can achieve improvements in AOD use, depression, anxiety, wellbeing and vocational engagement. Further, targeting self-regulation may enhance such programs.
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Affiliation(s)
- Catherine A. Quinn
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane 4072, Australia
- School of Psychology, The University of Queensland, Brisbane 4072, Australia
| | - Zoe C. Walter
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane 4072, Australia
- School of Psychology, The University of Queensland, Brisbane 4072, Australia
| | - Dominique de Andrade
- School of Psychology, The University of Queensland, Brisbane 4072, Australia
- School of Psychology, Deakin University, Melbourne 3125, Australia
| | - Genevieve Dingle
- School of Psychology, The University of Queensland, Brisbane 4072, Australia
| | - Catherine Haslam
- School of Psychology, The University of Queensland, Brisbane 4072, Australia
| | - Leanne Hides
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane 4072, Australia
- School of Psychology, The University of Queensland, Brisbane 4072, Australia
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Bax T. “I Had No Problems and Just Felt So Fabulous”: The “Storylines” of Methamphetamine Initiation in Aotearoa/New Zealand. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221134903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative life course-based study analyses the key circumstances preceding methamphetamine initiation. This paper utilizes Agnew’s “storylines” concept to analyse the background and situational factors that led 42 Aotearoa/New Zealanders to initiate methamphetamine. Multiple exposure to adversity across multiple life domains placed participants at heightened risk of early-onset drug use. Preceding methamphetamine initiation, the impact of social bonds and social roles were identified within the domains of family, romantic relationships, friendship and work. Whilst drug use onset broadly follows the stage theory sequence of drug use, participants did not initiate methamphetamine until age 27 on average. Initial use typically took place in a private setting among friends, family and co-workers. The initial effect was typically very positive, which greatly contributed to escalating use. Analysis revealed four main storylines, which highlight the importance of psychological state, social bonds, romantic attachments and social functioning in methamphetamine initiation.
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Affiliation(s)
- Trent Bax
- Department of Sociology, Ewha Womans University, South Korea
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28
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Neffa-Creech D, Plant A, Montoya JA, Oruga R, Kilgore EA, Fraser R, Tesema L. Development and evaluation of a social marketing campaign to address methamphetamine use in Los Angeles County. BMC Public Health 2022; 22:1796. [PMID: 36138397 PMCID: PMC9493153 DOI: 10.1186/s12889-022-14180-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
Background This study describes the development and impact of a social marketing campaign in early 2020 intended to prevent and reduce methamphetamine use in Los Angeles County (LAC). We used social marketing principles and the transtheoretical model to design the campaign, which was intended to avoid stigmatization of methamphetamine users and communicate compassion, empathy, and support. Methods To evaluate its impact, we collected cross-sectional online survey data post-campaign (n = 1,873) from LAC residents in population segments considered higher risk for methamphetamine use. We examine associations between campaign exposure and outcomes using bivariate analyses and binary logistic regression models, which control for the impact of the COVID-19 pandemic on methamphetamine use or likelihood of use. Results The analyses revealed that campaign exposure was associated with having more negative attitudes toward methamphetamine, calling LAC’s substance abuse service helpline, using methamphetamine fewer days, and considering abstaining. Frequency of exposure to campaign advertisements was positively associated with calling the helpline, suggesting a campaign dose effect. COVID-19-related factors were associated with using methamphetamine in the past 30 days. Conclusions Social marketing campaigns hold promise for impacting methamphetamine prevention and cessation behaviors. This study adds to the limited literature on mass marketing interventions to address this major health issue. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14180-y.
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Affiliation(s)
| | - Aaron Plant
- Sentient Research, 231 North Walnuthaven Drive, West Covina, CA, 91790, USA
| | - Jorge A Montoya
- Sentient Research, 231 North Walnuthaven Drive, West Covina, CA, 91790, USA
| | - Rangell Oruga
- Division of Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, 1000 South Fremont Avenue, Bldg A-9 East, 3rd Floor, Alhambra, CA, 91803, USA
| | | | - Renee Fraser
- Fraser Communications, 1631 Pontius Avenue, Los Angeles, CA, 90025, USA
| | - Lello Tesema
- Division of Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, 1000 South Fremont Avenue, Bldg A-9 East, 3rd Floor, Alhambra, CA, 91803, USA
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29
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Colledge-Frisby S, Jones N, Larney S, Peacock A, Lewer D, Brothers TD, Hickman M, Farrell M, Degenhardt L. The impact of opioid agonist treatment on hospitalisations for injecting-related diseases among an opioid dependent population: A retrospective data linkage study. Drug Alcohol Depend 2022; 236:109494. [PMID: 35605532 DOI: 10.1016/j.drugalcdep.2022.109494] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/05/2022] [Accepted: 05/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Injecting-related bacterial and fungal infections cause substantial illness and disability among people who use illicit drugs. Opioid agonist treatment (OAT) reduces injecting frequency and the transmission of blood borne viruses. We estimated the impact of OAT on hospitalisations for non-viral infections and examine trends in incidence over time. METHODS We conducted a retrospective cohort study using linked administrative data. The cohort included 47 163 individuals starting OAT between August 2001 and December 2017 in New South Wales, Australia, with 454 951 person-years of follow-up. The primary outcome was hospitalisation for an injecting-related disease. The primary exposure was OAT status (out of OAT, first four weeks of OAT, and OAT retention [i.e., more than four weeks in treatment]). Covariates included demographic characteristics, year of hospitalisation, and recent clinical treatment. RESULTS 9122 participants (19.3%) had at least one hospitalisation for any injecting-related disease. Compared to time out of treatment, retention on OAT was associated with a reduced rate of injecting-related diseases (adjusted rate ratio[ARR]=0.92; 95%CI 0.87-0.97). The first four weeks of treatment was associated with an increased rate (ARR 1.53, 95%CI 1.38-1.70), which we believe is explained by referral pathways between hospital and community OAT services. The age-adjusted incidence rates of hospitalisations for any injecting-related disease increased from 34.8 (95% CI =30.2-40.0) per 1000 person-years in 2001 to 54.9 (95%CI=51.3-58.8) in 2017. INTERPRETATION Stable OAT is associated with reduced hospitalisations for injecting-related bacterial infections; however, OAT appears insufficient to prevent these harms as the rate of these infections is increasing in Australia.
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Affiliation(s)
- Samantha Colledge-Frisby
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; Burnet Institute, Melbourne, Australia.
| | - Nicola Jones
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Sarah Larney
- CHUM Research Centre, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; School of Psychology, University of Tasmania, Hobart, Australia
| | - Dan Lewer
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Thomas D Brothers
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; UCL Collaborative Centre for Inclusion Health, Institute of Epidemiology and Health Care, University College London, London, UK; Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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Man N, Sisson SA, McKetin R, Chrzanowska A, Bruno R, Dietze PM, Price O, Degenhardt L, Gibbs D, Salom C, Peacock A. Trends in methamphetamine use, markets and harms in Australia, 2003-2019. Drug Alcohol Rev 2022; 41:1041-1052. [PMID: 35604870 DOI: 10.1111/dar.13468] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/18/2022] [Accepted: 03/10/2022] [Indexed: 12/19/2022]
Abstract
INTRODUCTION To describe trends in methamphetamine use, markets and harms in Australia from 2003 to 2019. METHODS Data comprised patterns of use and price from sentinel samples of people who inject drugs and who use MDMA/other illicit stimulants and population-level amphetamine-related police seizures, arrests, hospitalisations, treatment episodes and deaths from approximately 2003 to 2019. Bayesian autoregressive time-series models were analysed for: no change; constant rate of change; and change over time differing in rate after one to three changepoints. Related indicators were analysed post hoc with identical changepoints. RESULTS The percentage of people who inject drugs reporting weekly use increased from 2010 to 2013 onwards, while use among samples of people who regularly use ecstasy and other illicit stimulants decreased. Seizures and arrests rose steeply from around 2009/10 to 2014/15 and subsequently plateaued. Price increased ($15.9 [95% credible interval, CrI $9.9, $28.9] per point of crystal per year) from around 2009 to 2011, plateauing and then declining from around 2017. Hospitalisation rates increased steeply from around 2009/10 until 2015/16, with a small subsequent decline. Treatment also increased (19.8 episodes [95% CrI 13.2, 27.6] with amphetamines as the principal drug of concern per 100 000 persons per year) from 2010/11 onwards. Deaths involving amphetamines increased (0.285 per 100 000 persons per year) from 2012 until 2016. DISCUSSION AND CONCLUSIONS These findings suggest that problematic methamphetamine use and harms escalated from 2010 to 2012 in Australia, with continued demand and a sustained market for methamphetamine.
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Affiliation(s)
- Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Scott A Sisson
- School of Mathematics and Statistics, UNSW Sydney, Sydney, Australia.,UNSW Data Science Hub, UNSW Sydney, Sydney, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Paul M Dietze
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Daisy Gibbs
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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Yen CF, Ko CH, Hsu CY, Wu HC, Yang YY, Wang PW. A Pilot Randomized Control Study on Effect Brief Heart Rate Variability Biofeedback as a Complementary Treatment in Men with Methamphetamine Use Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095230. [PMID: 35564623 PMCID: PMC9105208 DOI: 10.3390/ijerph19095230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/17/2022] [Accepted: 04/24/2022] [Indexed: 11/24/2022]
Abstract
The aims of this study were to investigate the efficacy of heart rate variability biofeedback (HRVBFB) intervention in terms of reducing craving, severity of dependence, and rate of positive methamphetamine urine testing in men taking part in a methamphetamine use disorder outpatient treatment program. Sixty-one adult men received either HRVBFB treatment plus treatment as usual (TAU) over four weeks or TAU only. Men receiving HRVBFB showed significantly greater reductions in craving, dependence severity, and the rate of positive methamphetamine urine testing at the end of the intervention and four weeks of follow-up. The analyses further showed that the levels of craving and dependence severity at treatment entry were predictive of changes in craving and dependence severity at the end of treatment and follow-up, respectively. The baseline status of a positive methamphetamine urine test only predicted a positive methamphetamine urine test at the end of treatment, not at the end of the follow-up period. Our results showed HRVBFB intervention has merits as an adjunct treatment to ameliorate cravings and reduce the severity of dependence experienced by persons with methamphetamine use disorder. An added value of HRVBFB intervention is the fact that it can be easily and affordably implemented in everyday life.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (C.-F.Y.); (C.-H.K.); (Y.-Y.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (C.-F.Y.); (C.-H.K.); (Y.-Y.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chih-Yao Hsu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (C.-Y.H.); (H.-C.W.)
| | - Hung-Chi Wu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung 80276, Taiwan; (C.-Y.H.); (H.-C.W.)
| | - Yu-Yi Yang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (C.-F.Y.); (C.-H.K.); (Y.-Y.Y.)
| | - Peng-Wei Wang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (C.-F.Y.); (C.-H.K.); (Y.-Y.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-67-312-1101 (ext. 6822)
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Huang C, Yuan Q, Shi S, Ge M, Sheng X, Yang M, Zhang L, Wang L, Zhang K, Zhou X. Associations between alexithymia, parental rearing styles, and frequency of drug use in male methamphetamine dependence patients. BMC Psychiatry 2022; 22:276. [PMID: 35439989 PMCID: PMC9020116 DOI: 10.1186/s12888-022-03897-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alexithymia, which is characterized by difficulty identifying and describing feelings, is a stable personality trait and it has been associated with early life experiences. Methamphetamine dependence patients with high level of alexithymia may be particularly vulnerable to engaging in more frequent methamphetamine use. Therefore, we aimed to evaluate whether alexithymia was associated with frequency of methamphetamine use. Additionally, the current study sought to examine early-life factors associated with the development of alexithymia, i.e., parental rearing styles. METHOD Participants were 108 non-injecting methamphetamine dependent patients from a male compulsory detoxification center. The level of alexithymia was assessed by Toronto Alexithymia Scale-20(TAS-20). In addition, we applied Egna Minneu av. Bardndosnauppforstran (EMBU) to assess the parental rearing styles, including the dimensions of warmth, rejection, punishment/strictness, overinvolvement, overprotection, and favoring. RESULTS The total score of TAS-20 was positively correlated with frequency of methamphetamine use (r = 0.26, p < 0.01). Specifically, except for externally oriented thinking, difficulty identifying feelings (r = 0.23, p < 0.05) and difficulty describing feelings (r = 0.25, p < 0.05) were positively correlated with frequency of methamphetamine use. Multiple linear regression showed that more maternal rejection (B = 0.59, p = 0.002), or less maternal warmth (B = -0.22, p = 0.004) was associated with higher levels of alexithymia. Ordinal logistic regression showed that for every 1 score increase in the total score of TAS-20, there was a 1.06 times risk of a one level increase in the level of methamphetamine use frequency (OR = 1.06, p = 0.01). CONCLUSIONS These results have major implications for understanding the role of alexithymia in craving and addiction, while providing a further and explicit entry point for addiction treatment. Moreover, more attention should be focused on parenting in relation to early experiences.
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Affiliation(s)
- Cui Huang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Qiuyu Yuan
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Shengya Shi
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Menglin Ge
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Xuanlian Sheng
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Meng Yang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Ling Zhang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Lei Wang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032 Anhui Province China ,grid.459419.4Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000 China ,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000 China
| | - Kai Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032, Anhui Province, China. .,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000, China. .,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000, China.
| | - Xiaoqin Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, 69 Meishan Road, Hefei, 230032, Anhui Province, China. .,Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Chaohu City, Hefei, 238000, China. .,Anhui Psychiatric Center, 64 North Chaohu Road, Anhui Medical University, Hefei, 238000, China.
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Biddle TJ, Wermuth UD, Loughlin WA, Cresswell SL, White AR. Potential Forensic Markers from Synthetic Pathways to 1-Phenyl-2-propanone from Uncontrolled and Controlled Substances. Forensic Chem 2022. [DOI: 10.1016/j.forc.2022.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brookfield S, Selvey L, Maher L, Fitzgerald L. ‘Making Ground’: An Ethnography of ‘Living With’ Harmful Methamphetamine Use and the Plurality of Recovery. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426211073911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The trajectories of people attempting to reduce harmful methamphetamine use are frequently understood within a binary framework of transitioning between states of health and disease. This framework can often be reinforced by service interactions informed by these dominant narratives of recovery and addiction. In this paper, we draw on a critical interactionist analysis of ethnographic fieldwork conducted with people who use methamphetamine, to examine how their experiences could undermine this binary, observing the ways participants experienced growth, change, and progress, without necessarily maintaining abstinence. These findings support a more diverse understanding of drug use trajectories, and we explore the concept of ‘living with drug use’, similar to how people live with other chronic conditions by finding ‘health in illness’. Participant experiences are also interpreted within the context of counter public health, arguing for the recognition and integration of values and goals which are divergent from the implicit aims of public health practice.
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Affiliation(s)
- Samuel Brookfield
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Linda Selvey
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Lisa Maher
- Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia
| | - Lisa Fitzgerald
- School of Public Health, The University of Queensland, Brisbane, Australia
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35
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Jones CM, Houry D, Han B, Baldwin G, Vivolo-Kantor A, Compton WM. Methamphetamine use in the United States: epidemiological update and implications for prevention, treatment, and harm reduction. Ann N Y Acad Sci 2022; 1508:3-22. [PMID: 34561865 PMCID: PMC9097961 DOI: 10.1111/nyas.14688] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/04/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
Recent attention has focused on the growing role of psychostimulants, such as methamphetamine in overdose deaths. Methamphetamine is an addictive and potent stimulant, and its use is associated with a range of physical and mental health harms, overdose, and mortality. Adding to the complexity of this resurgent methamphetamine threat is the reality that the increases in methamphetamine availability and harms are occurring in the midst of and intertwined with the ongoing opioid overdose crisis. Opioid involvement in psychostimulant-involved overdose deaths increased from 34.5% of overdose deaths in 2010 to 53.5% in 2019-an increase of more than 50%. This latest evolution of the nation's overdose epidemic poses novel challenges for prevention, treatment, and harm reduction. This narrative review synthesizes what is known about changing patterns of methamphetamine use with and without opioids in the United States, other characteristics associated with methamphetamine use, the contributions of the changing illicit drug supply to use patterns and overdose risk, motivations for couse of methamphetamine and opioids, and awareness of exposure to opioids via the illicit methamphetamine supply. Finally, the review summarizes illustrative community and health system strategies and research opportunities to advance prevention, treatment, and harm reduction policies, programs, and practices.
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Affiliation(s)
- Christopher M. Jones
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Debra Houry
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland
| | - Grant Baldwin
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alana Vivolo-Kantor
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland
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Cumming C, Armstrong G, Borschmann R, Foulds JA, Newton-Howes G, McKetin R, Vallesi S, Preen D, Young J. Amphetamine-type stimulant use and self-harm: protocol for a systematic review of observational studies. BMJ Open 2022; 12:e057029. [PMID: 35074824 PMCID: PMC8788311 DOI: 10.1136/bmjopen-2021-057029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Amphetamine type stimulant (ATS) use and self-harm are both major public health concerns globally. Use of ATS is associated with a range of health and social problems, and has been increasing internationally in the last decade. Self-harm and ATS use share a number of underlying risk factors and occur at elevated rates in marginalised groups with high rates of exposure to trauma. The relationship between self-harm and ATS use is likely complex, and the causal pathway may run in either direction. A comprehensive review, synthesis and analysis of the evidence are warranted to investigate this relationship and inform policy and practice. METHODS AND ANALYSIS We will search the Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Scopus databases for relevant observational studies published in peer-reviewed journals. The initial search was conducted on 5 February 2021, with a final search expected on 1 February 2022. All studies will be independently screened by two reviewers, first on title and abstract, and then on full-text to determine inclusion in the review. We place no restriction on the population that studies investigate, our exposure of interest is both prescription and illicit ATS use, comparators will be those not currently using ATS, and our primary outcome of interest is the prevalence of self-harm. Data will be extracted using a predesigned template, and pooled prevalence and pooled measures of effect for the association between ATS use and self-harm. If sufficient data are available, we will perform multiple meta-analyses to produce pooled measures of effect for each measure of ATS exposure, as well as different population sub-groups. The Methodological Standard for Epidemiological Research scale will be used to assess study quality, and Egger's test and I2 values will be used to assess publication bias and heterogeneity, respectively. ETHICS AND DISSEMINATION No ethical approval is required for this review. We will only synthesise information from published studies that were conducted with ethical approval, so no individual participant data will be used. We will disseminate our findings via publication in a peer-reviewed journal, national and international conference presentations, and presentations to stakeholders in the community. TRIAL REGISTRATION NUMBER This study has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021226562).
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Affiliation(s)
- Craig Cumming
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Gregory Armstrong
- The University of Melbourne, Melbourne, Victoria, Australia
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - Rohan Borschmann
- The University of Melbourne, Melbourne, Victoria, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - James A Foulds
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, Canterbury, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Shannen Vallesi
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - David Preen
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jesse Young
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
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Jeong H, Yoon S, Sung YH, Kim J, Lyoo IK, Yurgelun-Todd DA, Renshaw PF. Effects of cytidine-5'-diphosphate choline on gray matter volumes in methamphetamine-dependent patients: A randomized, double-blind, placebo-controlled study. J Psychiatr Res 2021; 143:215-221. [PMID: 34507102 PMCID: PMC8557135 DOI: 10.1016/j.jpsychires.2021.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/07/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cytidine-5'-diphosphate choline (CDP-choline) has been suggested to exert neuroprotective and neuroreparative effects and may be beneficial for patients with stimulant dependence. This randomized, double-blind, placebo-controlled study in methamphetamine (MA) dependence investigated effects of CDP-choline on the brain structures and their associations with craving and MA use. METHODS MA users (n = 44) were randomized to receive 2 g/day of CDP-choline (n = 22) or placebo (n = 22) for 8 weeks. Patients underwent brain magnetic resonance imaging (MRI) at baseline and 8-week follow-up. Healthy individuals (n = 27) were also examined using brain MRI at the same interval. Voxel-based morphometry analysis was conducted to examine changes in gray matter (GM) volumes and their associations with craving and MA use. RESULTS Craving for MA was significantly reduced after the 8 week-treatment with CDP-choline (p = 0.01), but not with the placebo treatment (p = 0.10). There was no significant difference in the total number of MA-negative urine samples between the two groups (p = 0.19). With CDP-choline treatment, GM volumes in the left middle frontal gyrus (p = 0.001), right hippocampus (p = 0.009), and left precuneus (p = 0.001) were significantly increased compared to the placebo and control groups. Increased GM volumes in the left middle frontal gyrus with CDP-choline treatment were associated with reduced craving for MA (Spearman's ρ = -0.56, p = 0.03). In addition, the right hippocampal volume increases were positively associated with the total number of MA-negative urine results in the CDP-choline group (Spearman's ρ = 0.67, p = 0.006). CONCLUSION Our findings suggest that CDP-choline may increase GM volumes of MA-dependent patients, which may be related to decreases in MA use and craving.
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Affiliation(s)
- Hyeonseok Jeong
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
| | - Sujung Yoon
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Young-Hoon Sung
- The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Jungyoon Kim
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute and Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea,The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, UT, USA,College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | | | - Perry F. Renshaw
- The Brain Institute and Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
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McKetin R. Household surveys and the case of the Australian methamphetamine situation. Addiction 2021; 116:2610-2611. [PMID: 33754377 DOI: 10.1111/add.15480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Coughlin LN, Lin LA, Jannausch M, Ilgen MA, Bonar EE. Methamphetamine use among American Indians and Alaska Natives in the United States. Drug Alcohol Depend 2021; 227:108921. [PMID: 34333282 PMCID: PMC8782253 DOI: 10.1016/j.drugalcdep.2021.108921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent trends show methamphetamine use is increasing in the United States. American Indian and Alaska Native (AI/AN) communities face health disparities compared to the population overall, including some of the highest rates of illegal drug use. Herein, we examined the prevalence of methamphetamine use among AI/ANs and characteristics associated with methamphetamine use among AI/AN people. METHODS We examined past-year methamphetamine use from 2015 to 2019 between AI/ANs and the general non-institutionalized U.S. population using the National Survey of Drug Use and Health. Then, we identify potential subgroups of AI/AN people at elevated risk of methamphetamine use across factors including demographic, social determinants, mental health, and co-occurring substance use. RESULTS A total of 214,505 people, aged 18 or older, were surveyed between 2015 and 2019; 3,075 (0.55%) identified as AI/AN. An estimated 26.2 out of every 1000 AI/ANs used methamphetamine compared to 6.8 out of every 1000 in the general U.S. POPULATION Compared to methamphetamine use in the general population, AI/AN methamphetamine use tends to cluster in rural areas and among those with low income. AI/ANs who use methamphetamine were more likely to be male, middle-aged, low income, have severe mental illness, and misuse other substances than AI/AN people who did not use methamphetamine. DISCUSSION AI/ANs experience a disproportionate amount of methamphetamine use in the U.S. To address this disparity, multifaceted, broad prevention, harm reduction, and treatment efforts are needed that leverage cultural strengths to mitigate the consequences of methamphetamine use.
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Affiliation(s)
- Lara N Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Lewei Allison Lin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA; VA Center for Clinical Management Research (CCMR), Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, MI, 48109, USA
| | - Mary Jannausch
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA; VA Center for Clinical Management Research (CCMR), Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, MI, 48109, USA
| | - Mark A Ilgen
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA; VA Center for Clinical Management Research (CCMR), Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, MI, 48109, USA
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
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Kershaw S, Birrell L, Deen H, Newton NC, Stapinski LA, Champion KE, Kay-Lambkin F, Teesson M, Chapman C. Evaluation of a Digital Health Initiative in Illicit Substance Use: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e29026. [PMID: 34383690 PMCID: PMC8386404 DOI: 10.2196/29026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/30/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background The Cracks in the Ice (CITI) community toolkit was developed to provide evidence-based, up-to-date information and resources about crystal methamphetamine to Australians. Given the high rates of internet use in the community and the potential for misinformation, CITI has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal methamphetamine. Objective This study aims to determine (1) whether the CITI toolkit is achieving its aim of disseminating evidence-based information and resources to people who use crystal methamphetamine, their family and friends, health professionals, and the general community and (2) examine the association between the use of CITI and the knowledge and attitudes about crystal methamphetamine. Methods A cross-sectional web-based survey, open to Australian residents (aged ≥18 years), was conducted from November 2018 to March 2019. People who had previously visited the website (referred to as “website visitors” in this study) and those who had not (“naïve”) were recruited. At baseline, knowledge, attitudes, and demographics were assessed. CITI website visitors then completed a series of site evaluation questions, including the System Usability Scale (SUS), and naïve participants were asked to undertake a guided site tour of a replicated version of the site before completing the evaluation questions and repeating knowledge and attitude scales. Results Of a total 2108 participants, 564 (26.7%) reported lifetime use of crystal methamphetamine, 434 (20.6%) were family/friends, 288 (13.7%) were health professionals, and 822 (38.9%) were community members. The average SUS score was 73.49 (SD 13.30), indicating good site usability. Health professionals reported significantly higher SUS scores than community members (P=.02) and people who used crystal methamphetamine (P<.001). Website visitors had significantly higher baseline knowledge than naïve participants (P<.001). Among naïve participants, knowledge scores increased following exposure to the website (mean 15.2, SE 0.05) compared to baseline (mean 14.4, SE 0.05; P<.001). The largest shifts in knowledge were observed for items related to prevalence, legal issues, and the effects of the drug. Stigmatizing attitude scores among the naïve group were significantly lower following exposure to CITI (mean 41.97, SE 0.21) compared to baseline (mean 44.3, SE 0.21; P<.001). Conclusions This study provides an innovative evaluation of a national eHealth resource. CITI is achieving its aim of disseminating evidence-based, nonstigmatizing, and useful information and resources about crystal methamphetamine to key end user groups and has received good usability scores across its target groups. Interaction with CITI led to immediate improvements in knowledge about crystal methamphetamine and a decrease in stigmatizing attitudes. CITI demonstrates the important role of digital information and support platforms for translating evidence into practice and improving knowledge and reducing stigma.
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Affiliation(s)
- Steph Kershaw
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Hannah Deen
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Newcastle, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Lappin JM, Darke S. Methamphetamine and heightened risk for early-onset stroke and Parkinson's disease: A review. Exp Neurol 2021; 343:113793. [PMID: 34166684 DOI: 10.1016/j.expneurol.2021.113793] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/09/2021] [Accepted: 06/19/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Methamphetamine users are typically young adults, placing them at risk for significant drug-related harms. Neurological harms include stroke and Parkinson's disease, both of which may develop prematurely in the context of methamphetamine use. MATERIAL AND METHODS We conducted a narrative review examining the evidence first, for stroke under 45 years and second, early onset of Parkinson's disease (PD) and parkinsonism related to methamphetamine use. We summarise epidemiological factors and common clinical features, before examining in detail the underlying pathology and causal mechanisms. RESULTS AND DISCUSSION Methamphetamine use among young people (<45 years) is associated with heightened risk for haemorrhagic stroke. Compared to age-matched all-cause fatal stroke, haemorrhage secondary to aneurysmal rupture is more common among young people with methamphetamine-related stroke and is associated with significantly poorer prognosis. Aetiology is related primarily to both acute and chronic hypertension associated with methamphetamine's sympathomimetic action. Evidence from a variety of sources supports a link between methamphetamine use and increased risk for the development of PD and parkinsonism, and with their early onset in a subset of individuals. Despite this, direct evidence of degeneration of dopaminergic neurons in methamphetamine users has not been demonstrated to date. CONCLUSIONS Stroke and Parkinson's Disease/parkinsonism are neurological harms observed prematurely in methamphetamine users.
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Affiliation(s)
- Julia M Lappin
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia; School of Psychiatry, University of New South Wales, NSW, Australia.
| | - Shane Darke
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia
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Raftery D, Kelly PJ, Deane FP, Carter G, Dean OM, Lubman DI, Turner A, McKetin R. Cognitive insight, medication adherence and methamphetamine cessation in people enrolled in a pharmacotherapy trial for methamphetamine use. J Subst Abuse Treat 2021; 130:108473. [PMID: 34118709 DOI: 10.1016/j.jsat.2021.108473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The current study examined correlates of cognitive insight in people enrolled in a methamphetamine pharmacotherapy trial; whether cognitive insight at the start of the trial predicted medication adherence and reductions in methamphetamine use during the trial; and, whether insight would remain stable over the trial or improve with reductions in methamphetamine use. METHODS A subset of people enrolled in a 12-week randomised placebo-controlled pharmacotherapy trial for methamphetamine dependence completed the Beck Cognitive Insight Scale, comprising subscales for Self-Reflection and Self-Certainty, at baseline (n = 152) and at week 12 (n = 79). Medication adherence was expressed as the percentage of non-missed doses measured using eCAP™ technology. Methamphetamine use days were assessed using the Timeline Followback. RESULTS At baseline, greater Self-Reflection was correlated with more severe methamphetamine withdrawal, and hostility, whereas Self-Certainty was correlated with less education and longer duration of methamphetamine use. No relationship was found between BCIS subscales at baseline and medication adherence (Self-Reflection b[SE] = -0.73 [0.43] p = .09; Self-Certainty b[SE] = -0.31 [0.48] p = .52,). Neither BCIS subscale was predictive of reduced methamphetamine use at 12 weeks (Self-Reflection b[SE] = 0.001 [0.01] p = .95 Self-Certainty b[SE] = -0.003 [0.01], p = .74). Self-Reflection decreased over the trial (t = 3.42, p = .001) but this was unrelated to change in methamphetamine use (Self-Reflection, b[SE] = -1.68 [1.16] p = .15) Change in methamphetamine use was found to be a significant predictor of Self-Certainty at 12 weeks (b [SE] = -2.71 [1.16] p = .02). CONCLUSIONS We found no evidence that cognitive insight predicted medication adherence or methamphetamine reduction in people engaged in this trial. Ongoing or increased methamphetamine use predicted increased Self-Certainty at 12 weeks.
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Affiliation(s)
- Dayle Raftery
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia.
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia
| | - Gregory Carter
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, NSW, Australia
| | - Olivia M Dean
- Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Australia; Turning Point, Eastern Health, Richmond, Australia
| | - Alyna Turner
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, NSW, Australia; Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Pisarski K. A Narrative Review of the Recent 'Ice' Epidemic: An Australian Perspective. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2021; 15:11782218211010502. [PMID: 33958872 PMCID: PMC8064659 DOI: 10.1177/11782218211010502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/14/2021] [Indexed: 11/25/2022]
Abstract
Background: The use of methamphetamine or amphetamine stimulant drugs has been identified by authoritative public health bodies as a global health issue, with a worrying trend towards production and consumption of a higher purity crystalline form methamphetamine (ice) over the past decade. This trend has been well documented within Australia, resulting in a public perception of there being an ‘ice’ epidemic in regional/rural areas. Considering the illicit nature of ice, monitoring it is challenging and as such little information is available regarding the actual extent of methamphetamine use, harms and patterns in regional/remote Australia. Aim: To collate the available literature regarding methamphetamine use in regional/rural Australia and identify gaps in the literature. Methods: A literature search was conducted by searching 6 databases (PUBMED, Medline, CINAHL, EMBASE, PsycINFO and SCOPUS) following which exclusion/inclusion criteria were applied. Included papers were appraised with the Joanna Briggs Institute Critical appraisal tools and synthesised in light of the sociocultural, ethnic and geographic differences in methamphetamine use in Australia. Results: Regarding rural/regional Australia there is a significant lack of research into methamphetamine use, patterns and epidemiology since the rise of crystalline methamphetamine in 2013. The existing literature available suggests great variability in methamphetamine harms in rural communities. This can be a double-edged sword however, as the introduction of ice into a remote/rural community may result in greater harms if it becomes ingrained in local customs. Similarly, there is a lack of research into the specific factors within Indigenous communities leading to an increased rate of methamphetamine use amongst members. Recommendation: Future research should address the causes of variance in methamphetamine harms in rural/remote regions. Although the scope of this paper was the Australian context, a wider international approach may yield useful information.
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Affiliation(s)
- Konrad Pisarski
- Division of Tropical Health & Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Faculty of Medicine, University of Queensland, Herston, St Lucia, QLD, Australia
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Schumann J, Perkins M, Dietze P, Nambiar D, Mitra B, Gerostamoulos D, Drummer OH, Cameron P, Smith K, Beck B. The prevalence of alcohol and other drugs in fatal road crashes in Victoria, Australia. ACCIDENT; ANALYSIS AND PREVENTION 2021; 153:105905. [PMID: 33631704 DOI: 10.1016/j.aap.2020.105905] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 11/18/2020] [Accepted: 11/21/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Driving under the influence of drugs, including alcohol, is a globally recognised risk factor for road traffic crashes. While the prevalence of alcohol and other drugs in fatal road crashes has been examined in other countries, recent data investigating drug driving in fatal Australian crashes are limited. This study aimed to examine how the presence of alcohol and other drugs in fatal road trauma in Victoria has changed over time in different road users. METHODS A population-based review of road trauma deaths was performed over the period of 01 July 2006 to 30 June 2016 in Victoria, Australia, using data from the National Coronial Information System (NCIS) and the Victorian State Trauma Registry (VSTR). Drugs were grouped according to type and analysed accordingly. Poisson regression models were used to determine change in incidence rates over the study period. RESULTS There were 2287 road traffic fatalities with complete toxicology data (97% of all road traffic fatalities). Alcohol (blood alcohol concentration, BAC) was the most commonly detected drug (>0.001 g/100 mL: 21.1%; >0.05 g/100 mL: 18.4%), followed by opioids (17.3%), THC (13.1%), antidepressants (9.7%), benzodiazepines (8.8%), amphetamine-type stimulants (7.1%), ketamine (3.4%), antipsychotics (0.9%) and cocaine (0.2%). Trends demonstrated changing use over time with specific drugs. Alcohol positive road fatalities declined 9% per year in passenger car/4WD drivers (IRR = 0.91, 95% CI: 0.88-0.95). The incidence of strong opioids (oxycodone, fentanyl, morphine, and methadone) increased 6% per year (IRR = 1.06; 95% CI: 1.02-1.10). Methylamphetamine was detected in 6.6% of cases and showed a yearly increase of 7% (IRR = 1.07; 95% CI: 1.01-1.13). The incidence of THC remained unchanged over the period, observed in 13.1% of cases. Stronger opioids were more commonly detected among pedal cyclists (19.0%) and pedestrians (20.9%) while THC was more commonly detected among motorcyclists (19.8%) and other light vehicle drivers (17.6%). CONCLUSIONS A decline in the prevalence of alcohol in fatalities suggests that law enforcement and public health strategies in Australia to address road fatalities and drink-driving may have had a positive effect. However, increases were observed in the incidence of other potentially impairing drugs including opioids and amphetamines, specifically methylamphetamine, indicating a concerning trend in road safety in Victoria that warrants further monitoring.
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Affiliation(s)
- Jennifer Schumann
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Australia.
| | - Monica Perkins
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Paul Dietze
- Burnet Institute, Victoria, Australia; National Drug Research Institute, Victoria, Australia
| | - Dhanya Nambiar
- Eastern Clinical School, Monash University, Victoria, Australia
| | - Biswadev Mitra
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia
| | - Dimitri Gerostamoulos
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Australia
| | - Olaf H Drummer
- Victorian Institute of Forensic Medicine, Victoria, Australia; Department of Forensic Medicine, Australia
| | - Peter Cameron
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Victoria, Australia
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia; Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
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McKetin R, Chrzanowska A, Man N, Peacock A, Sutherland R, Degenhardt L. Trends in treatment episodes for methamphetamine smoking and injecting in Australia, 2003–2019. Drug Alcohol Rev 2021; 40:1281-1286. [DOI: 10.1111/dar.13258] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/04/2021] [Accepted: 01/09/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
| | - Nicola Man
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
- School of Psychology University of Tasmania Hobart Australia
| | - Rachel Sutherland
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
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46
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Fitzpatrick RE, Robinson AH, Rubenis AJ, Lubman DI, Verdejo-Garcia A. Lack of longitudinal changes in cognition in individuals with methamphetamine use disorder during the first 6 weeks after commencing treatment. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:383-392. [PMID: 33524275 DOI: 10.1080/00952990.2020.1869243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Methamphetamine use disorder (MUD) associates with cognitive impulsivity deficits. However, few studies have examined longitudinal changes in cognition, and it remains unclear if deficits resolve during early recovery.Objectives: To compare: (1) cognitive function of individuals with MUD at treatment onset and six-weeks later with controls tested over the same period; (2) cognitive changes in MUD-individuals who remained abstinent versus relapsed.Method: We recruited 108 participants meeting DSM-IV-TR criteria for methamphetamine dependence (81 males) and 50 demographically matched controls (38 males); 77 methamphetamine- dependent participants (59 males) and 48 controls (36 males) were retained at follow-up. We administered response inhibition, delay discounting and uncertainty-based decision-making tests at both endpoints. Relapse was defined as methamphetamine concentrations >0.4 ng/mg at follow-up in hair toxicology.Results: We found a significant time-by-group interaction on uncertainty-based decision-making (effect size: η2 = .05), although post-hoc tests to disentangle this interaction yielded inconclusive results (p-range = .14-.40; BF10-range = 0.43-1.67). There were no significant time-by-group interactions on response inhibition or delay discounting, with the former likely a null effect (η2-interaction = .003 and .02; BFincl = 0.23 and 0.71). There were no significant differences in cognitive recovery between individuals who maintained abstinence (n = 12) versus relapsed (n = 65) (η2-range = .003-.04), although evidence was inconclusive toward whether findings reflected true null effects (BFincl-range = 0.33-0.75).Conclusion: We did not find evidence that MUD-related cognitive impulsivity deficits improve beyond practice effects over 6 weeks. Findings do not support previous, albeit conflicting, evidence of early recovery of cognitive deficits in MUD.
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Affiliation(s)
- Rebecca E Fitzpatrick
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Alex H Robinson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Adam J Rubenis
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia.,Turning Point, Eastern Health, Monash University, Fitzroy, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Monash University, Fitzroy, Australia.,Eastern Health Clinical School, Monash University, Fitzroy, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia.,Turning Point, Eastern Health, Monash University, Fitzroy, Australia
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Gjersing L, Helle MK. Injecting Alone is More Common among Men, Frequent Injectors and Polysubstance Users in a Sample of People Who Inject Drugs. Subst Use Misuse 2021; 56:2214-2220. [PMID: 34565289 DOI: 10.1080/10826084.2021.1981388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Injecting alone increases the risk of a fatal overdose. We examined the extent of such behavior in a sample of people who inject drugs (PWID) and the typical characteristics of those injecting alone at least once during the past four weeks. A cross-sectional study. PWID recruited from the street and from low-threshold services in seven Norwegian cities in September 2017 (n = 359). Associations between characteristics and injecting alone were examined using logistic regression analysis. The independent variables were gender (female/male), age, having received overdose-prevention education (no/yes), and, in the past four weeks; homelessness/shelter use (no/yes), in opioid substitution treatment (no/yes), injecting ≥ four days a week (no/yes), and substances injected (opioids only/opioids and other/other only/central stimulants (CS) only/CS and other/CS and opioids/CS, opioids and other). The adjusted odds ratios (aOR) and 95% Confidence Intervals (CI) were reported. Of the 359 PWID, 84.4% reported having injected alone. Males were more likely than females to inject alone (aOR = 1.88 95% CI 1.00-3.54). Furthermore, those injecting frequently (aOR = 1.99 95% CI 1.02-3.86) and those injecting multiple substances (CS, opioids and other) (aOR = 2.94 95% CI 1.01-8.58) were more likely to inject alone compared to those injecting less frequently and opioids only. Although not statistically significant, the effect sizes in the logistic regression models suggest that polysubstance use may be driven by CS use. Injecting alone was common in our sample of PWID, and male gender, frequent injecting and polysubstance injecting were associated with this behavior.
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Affiliation(s)
- Linn Gjersing
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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48
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Deen H, Kershaw S, Newton N, Stapinski L, Birrell L, Debenham J, Champion KE, Kay-Lambkin F, Teesson M, Chapman C. Stigma, discrimination and crystal methamphetamine (‘ice’): Current attitudes in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 87:102982. [DOI: 10.1016/j.drugpo.2020.102982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022]
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Puljević C, Zahnow R, Benfer I, Winstock AR, Maier LJ, Barratt MJ, Ferris J. Patterns of methamphetamine production among an international sample of methamphetamine 'cooks'. Drug Alcohol Rev 2020; 40:1287-1293. [PMID: 33170968 DOI: 10.1111/dar.13205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS The illicit manufacture of methamphetamine in clandestine laboratories is associated with significant risks to the community and environment. Currently little is known about clandestine laboratories or the individual 'cooks' who operate them; current research directly engaging with cooks is limited to three qualitative studies with small samples (n < 24) of cooks based in the USA. This descriptive brief report starts to address this knowledge gap by exploring characteristics of an international sample of self-identified methamphetamine cooks. DESIGN AND METHODS Using data from the 2017 and 2018 Global Drug Surveys, we identified 125 individuals from 24 countries who reported past manufacture of methamphetamine. We explored respondents' socio-demographic characteristics and patterns of methamphetamine production using descriptive statistics. RESULTS The majority of methamphetamine cooks were male (82%) and Caucasian (70%) and, contrary to previous studies, 43% were employed and 51% had at least a high school certificate. Cooks most commonly sourced precursors from pharmacies (50%), followed by friends (24%). Almost half of the cooks (47%) produced methamphetamine exclusively for self-consumption. DISCUSSION AND CONCLUSIONS The heterogeneous nature of the sample and varying precursor sources reflect the limitations of existing regulations aimed at limiting methamphetamine production. These findings point to the need for innovative and multi-faceted efforts aimed at reducing and preventing the harms associated with methamphetamine manufacture.
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Affiliation(s)
- Cheneal Puljević
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia
| | - Renee Zahnow
- School of Social Science, The University of Queensland, Brisbane, Australia
| | - Isabella Benfer
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Adam R Winstock
- Faculty of Population Health Sciences, University College London, London, UK.,Global Drug Survey Ltd, London, UK
| | - Larissa J Maier
- Department of Clinical Pharmacology, University of California San Francisco, San Francisco, USA
| | - Monica J Barratt
- Social and Global Studies Centre, RMIT University, Melbourne, Australia.,National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Jason Ferris
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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50
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Kaye S, Lewandowski A, Bowman J, Doyle MF. Crystal methamphetamine use among young people entering custody: Prevalence, correlates and comorbidity. Drug Alcohol Rev 2020; 40:1266-1274. [PMID: 33155354 DOI: 10.1111/dar.13210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND AIMS Crystal methamphetamine (CM) is associated with a range of physical and mental health harms and may be of particular concern among young people at risk of early, problematic substance use, such as those in contact with the criminal justice system. This study aimed to investigate the prevalence and correlates of regular (i.e. at least weekly) CM use among young people preceding entry into custody. DESIGN AND METHODS Data were collected from 207 participants aged 14-18 years as part of the 2015 Young People in Custody Health Survey, a cross-sectional survey of youth in custody in New South Wales, Australia. Participants were administered face-to-face structured interviews assessing sociodemographic, childhood and family characteristics, offending history, substance use and psychopathology. Multivariable logistic regression analyses were conducted to identify factors independently associated with regular CM use. RESULTS Regular CM use was reported by 31% of participants and was independently associated with higher levels of antisocial traits/behaviour [adjusted odds ratio (AOR) 1.13, 95% confidence interval (CI) 1.02, 1.25], increased polydrug use (AOR 1.34, 95% CI 1.14, 1.58), injecting drug use (AOR 4.06, 95% CI 1.02, 16.16) and meeting symptom thresholds for two or more current psychological disorders (AOR 3.20, 95% CI 1.15, 8.94). DISCUSSION AND CONCLUSIONS Regular CM users present with more complex comorbidity than other young people in custody, increasing the health-care burden in custodial and community settings. Early identification and appropriate treatment of this comorbidity is crucial to improving the health, psychosocial and behavioural outcomes of this vulnerable group.
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Affiliation(s)
- Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia.,National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Lewandowski
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Julia Bowman
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Michael F Doyle
- Centre of Research Excellence Indigenous Health and Alcohol, Sydney Medical School, University of Sydney, Sydney, Australia
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